Travel burden and carbon dioxide emission reductions through a model of cancer care closer to the patient.

Background: Traveling to healthcare facilities, particularly in the case of patients requiring frequent visits and repeated treatments, such as cancer patients, is associated with substantial carbon dioxide (CO2) emissions. Moreover, travel burdens can delay diagnosis and negatively influence prognosis.

Methods: In 2004, a programme called territorial oncology care (TOC) was initiated in the province of Piacenza (northern Italy) to relieve travel burdens by providing treatment closer to patients' residences. Patient management is performed by oncologists traveling from the city hospital's oncologic ward to rural centers. Patients are managed at 3 rural hospitals and a health center called Casa della Salute. In this study, we retrospectively analyzed all files containing the schedules of patients enrolled in the TOC programme from 2 January 2017 to 31 December 2022. We calculated the driving distance (in kilometers) to the outpatient facility closest to each patient's residence and the CO2 emissions saved compared with the distance to the city hospital.

Results: A total of 2132 cancer patients on active treatment were enrolled in the TOC programme during the study period. The total travel saved by treating patients closer to their residences over this 6-year period amounted to 1 975 105 km, representing carbon emission savings of 241.56 tonnes.

Conclusions: Our findings show a significant reduction (241.56 tonnes) of CO2 emissions for the entire cohort of patients over a period of 6 years.Cancer patients' travel burdens and associated carbon emissions can be substantially reduced by programmes such as TOC.