TRAVEL DISTANCE FOR RADIOTHERAPY IN NIGERIA: A RETROSPECTIVE ANALYSIS OF CASES MANAGED AT A RADIOTHERAPY CENTER. REVISED MANUSCRIPT

Background Travel distance affects access to healthcare services and can influence service utilization and patient outcomes in cancer care. In Nigeria, the limited availability of radiotherapy facilities, uneven geographical distribution, and unpredictable equipment functionality make patients to travel long distances to access treatment. Objectives This study examined the actual distance travelled by patients to access radiotherapy at Ahmadu Bello University Teaching Hospital, Zaria. Materials and Methods This was a retrospective chart review of patients treated for cervical, breast, and nasopharyngeal cancers at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, between 2010 and 2014. Data collected included the shortest road distance from the capital city of each patient’s state of residence to Zaria, the distance to the nearest radiotherapy centre, radiotherapy waiting time (in days), and cancer stage. Descriptive statistics were used to summarize variables. Spearman’s correlation and multiple linear regression were used to examine the relationship between waiting time and travel distance. Results A total of 233 cases were reviewed: cervical (55%), breast (31%), and nasopharyngeal cancers (14%). Most patients were female (92%), with a mean age of 46.7 ± 12.0 years. The mean travel distance to Zaria was 407 ± 250.1 km. The mean waiting time was 162 ± 192.7 days. A weak but statistically significant negative correlation was observed between travel distance and waiting time. This finding was confirmed in the regression model, where travel distance was the only significant predictor of waiting time. However, the effect size was small, and the model explained only a limited proportion of variance (R² = 0.092). Conclusion This study shows that travel distances exceed the recommended threshold. Optimizing currently available radiotherapy centres in Nigeria is necessary to reduce travel burden and treatment delays