The Cost of Distance: How Travel for Pediatric Cancer Care Affects Parental Income-A Danish Registry-Based Cohort...

To evaluate whether the distance between residence and treatment location for children with cancer affects parents' income trajectories, focusing on differences between men and women.

We conducted a nationwide, registry-based cohort study including all children aged 0-14 years diagnosed with cancer in Denmark between 1996 and 2016. Outcome measures were differences in parents' income from 1 year before diagnosis to 2 and 5 years after.

Across all models, a negative association were found between distance to treatment and income trajectories. This indicates that a longer distance to treatment may result in slower income growth 2 and 5 years after a child's cancer diagnosis, relative to the year preceding diagnosis. For mothers, the smaller income gains over time are more pronounced in the models including income 5 years post diagnosis, while the effect is almost identical for fathers across the two models. When comparing results for fathers and mothers, the coefficient is greater for fathers in the model including income 2 years after diagnosis, while the coefficient is greater for mothers 5 years after diagnosis. Yet, the only significant associations (p < 0.05) was found in baseline models including income 5 years after diagnosis, and a near significant for association in the adjusted model for mothers.

For families of children with cancer in Denmark, a greater distance to the treating center may contribute to a deceleration in income trajectories.