NEARLY 1 IN 3 CHILDREN WITH CANCER travel more than an hour to receive treatment, and about 1 in 8 cross state lines, according to a study presented at the 19th American Association for Cancer Research (AACR) Conference on The Science of Cancer Health Disparities, held Oct. 18 to 21, 2026, in Atlanta. (The AACR publishes Cancer Today.)

Because pediatric cancer care is highly specialized, community hospitals often do not offer cancer treatment for children, and dedicated pediatric cancer hospitals are less common in the U.S. than centers for adults. As a result, pediatric patients and their families may need to travel long distances to receive treatment.

Travel can create a financial burden for families as bills for transportation, hotel stays and other expenses add up. “Prior research has shown that parents often experience lost wages, child care expenses for siblings, and expenses related to travel and accommodation—expenses that are not incurred by many adult cancer patients,” Erin Marcotte, a study author and pediatric cancer epidemiology researcher at the University of Minnesota in Minneapolis, said in a press release.

For some children with cancer, the nearest hospital is in the next state, which can further complicate access to care. Some insurance plans do not cover out-of-state care, and patients may be unable to use telehealth from their home if their doctor is not licensed in that state.

All these potential barriers can prevent children with cancer from receiving quality care, according to Marcotte. “Access to care has implications for timely diagnosis, financial and time toxicity, and, ultimately, outcomes for pediatric patients,” she said.

To assess which patients are most at risk for travel-related concerns, Marcotte and colleagues analyzed nationwide cancer registry data from 2007 to 2017 for 49,434 children and adolescents diagnosed with cancer before turning 22. They looked at where patients lived, where they received care and the estimated travel time from home to the hospital.

The researchers found 32.4% of patients traveled an hour or more to receive treatment, while about 20% traveled 90 minutes or more. Additionally, nearly half of patients lived more than 90 minutes away from a pediatric cancer center that offered phase I/II clinical trials. “This finding is particularly important because it indicates that travel time may be a more significant barrier to accessing novel treatments than previously recognized,” Marcotte said.

People who lived in small, rural towns, lived in the Midwest or the South, or were American Indian/Alaska Native had the longest median travel times, the study found.

In addition, researchers found 13.3% of patients crossed state borders to receive cancer treatment. People with the highest social vulnerability—determined by factors like poverty, housing insecurity and transportation access in the patient’s community—were about 62% less likely to receive interstate care than those with the lowest social vulnerability.

“The pediatric cancer community needs to be very intentional about increasing accessibility to both routine care and clinical trials,” Marcotte said. “We should actively pursue upstream interventions such as improved infrastructure, partnerships with community hospitals and clinics to decentralize aspects of care when possible, and advocacy for federal policies that remove barriers to timely care.”

Thomas Celona is a senior editor at Cancer Today.