Published Aug 26, 2026 | 7:00 AM ⚊ Updated Aug 26, 2026 | 7:00 AM
Children with solid tumours travelled a median of 173 minutes, compared with 160 minutes for those with blood cancers.
Synopsis: A new study of 22,328 children with cancer found that families in India often travel long distances for specialised paediatric cancer care. Chennai’s WIA Cancer Institute recorded the longest median travel time at nearly four-and-a-half hours, highlighting gaps in specialist care, delayed treatment, financial strain and the need for decentralised services.
A child diagnosed with cancer outside Chennai may have to travel four hours or more to reach the city for advanced cancer care. Families board buses, hire cars and cross state lines, often travelling hundreds of kilometres with their children, carrying test reports, medical records and the hope of finding specialised treatment.
A new study, published in the Journal of Cancer Policy, tracked 22,328 children and teenagers diagnosed with cancer across India between 2005 and 2019. It measured how long it took a child to reach for treatment at three hospitals: the All India Institute of Medical Sciences (AIIMS) and Rajiv Gandhi Cancer Institute and Research Centre (RGCI), both in New Delhi, and the Women’s Indian Association (WIA) Cancer Institute in Chennai.
At WIA, the median travel time reached 266 minutes, nearly four and a half hours. More than 80% of patients from WIA had to travel more than 2 hours for treatment, which is much higher than the other 2 facilities included in the study.
Researchers mapped patient addresses against hospital locations and calculated motorised travel time using road, rail and terrain data. The pattern that emerged placed WIA at the centre of a wide catchment stretching across southern India, pulling families from far beyond Tamil Nadu.
“Patients treated at WIA in Chennai experienced the longest median motorised travel times and the highest burden of prolonged travel across all sub-groups,” the authors wrote.
They linked this to WIA’s function as a referral hub for the south, a role that draws children from distances few hospitals elsewhere in the country cover. The study calculated a Gini coefficient, a measure of spread, and found WIA’s patient base clustered at distance rather than scattering unevenly. Families did not simply live far away by chance. They travelled far because options nearer home ran short.
Compare this with Delhi. At AIIMS, the median travel time measured 151 minutes. At RGCI, a private hospital, it dropped to 109 minutes. After adjusting for age, sex and cancer type, children treated at WIA carried 2.79 times the odds of travelling over an hour compared with those treated at AIIMS.
“When a child has to travel for four hours to Chennai for treatment, it is a devastating set of events that has risen due to the limitations in our healthcare system, due to unavailability of specialist paediatric cancer care. This forces these children and their families to travel longer distances to access life saving treatment and care,” Dr Akshithanand KJ , lead author of the study, told South First.
He traced the fallout through what researchers call the three delays model.
“The poor geographic accessibility can be a reason for, a) delay in choosing to seek care, b) delay in diagnosis, and c) delay in treatment initiation, as explained by the three delays model,” he said.
The cost lands hardest on families with the least to spare, he added.
“This poor access disproportionately affects the socio-economically weaker section of the community, with repeated travel costs, loss of wages, leading to catastrophic health expenditure, exacerbating the suffering, forcing these children to drop out of treatment, poor follow-up, and thus decreasing the chances of their survival,” Akshithanand said.
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Across all three hospitals, the median travel time stood at 161 minutes, just under two hours and 45 minutes. Only 26.5% of families reached treatment within half an hour. Over 60%, or 13,570 children, travelled more than two hours. Nearly 68% crossed the one-hour mark.
Researchers built the estimates from postal codes, district centroids and satellite mapping, then estimated the travel time to reach the particular healthcare facility taking into consideration the road-and-terrain network for each child. The method did not take into consideration whether the families had access to motorised vehicles, did not track whether they relocated near a hospital during treatment.
The study has not included families who never reached the hospitals.
“Our analysis is an optimistic estimate of access to childhood cancer care,” the authors noted.
The study also found a gap between sons and daughters.
“Boys had 23% higher odds of travelling more than 60 min compared to girls, a disparity that persisted after adjustment for age, diagnosis, and treating centre,” the study stated.
The authors linked this to patterns documented earlier in Indian childhood cancer research, where families invest more readily in care for sons than daughters, particularly once travel and cost climb.
“This finding may reflect broader gender-based inequalities in healthcare-seeking behaviour in India, where families may be more willing to invest time and resources in accessing care for male children,” the authors wrote.
Japan, by contrast, recorded no gender gap in a similarly designed study, pointing to a divide rooted in socio-cultural factors rather than geography alone.
Cancer type also shaped the journey. Children with solid tumours travelled a median of 173 minutes, compared with 160 minutes for those with blood cancers. After adjustment, children with solid tumours carried 9% higher odds of crossing the one-hour threshold.
Retinoblastoma, a cancer of the eye, produced the longest median journey among solid tumours at 242 minutes, just over four hours. Among blood cancers, acute myeloid leukaemia led at 187 minutes.
The authors traced this gap to infrastructure. Blood cancers often respond to chemotherapy, available at a wider spread of centres. Solid tumours frequently demand surgery and radiotherapy, services concentrated in fewer hospitals.
The researchers set their findings against studies from other countries. In the United States, the median travel time to a paediatric oncologist measures 20 minutes, with only 16.7% of families crossing the one-hour mark. In Japan, the median stands at 37 minutes, with 21.7% travelling beyond an hour.
India’s figures sit closer to other middle-income countries. In Saudi Arabia, 32% of patients travelled beyond three hours. Studies from Colombia and also Brazil recorded similar patterns.
“These similarities suggest that access challenges in India may share commonalities with other developing nations, potentially driven by vast geographic expanses and limited healthcare infrastructure,” the authors wrote.
The map behind the study tells its own story. Lines stretch from AIIMS across Uttar Pradesh, Bihar and Haryana, states that together supplied over 40% of the patients in the study. New Delhi itself contributed 19%. Tamil Nadu, home to WIA, supplied 18%.
The pattern shows two kinds of pull. AIIMS, funded by the government and offering subsidised treatment, draws children from a wide belt of northern India as a national referral point. RGCI, a private hospital, serves a population that clusters closer to Delhi, though it too pulls a smaller group from farther out.
“While RGCI primarily serves a geographically concentrated local population, it also attracts a smaller proportion of patients from distant locations,” the authors wrote. “AIIMS, as a publicly funded tertiary referral centre, appears to serve a more geographically diverse patient population, consistent with its role as a major publicly funded national referral institution.”
Age barely shifted the numbers. Children aged 15 to 19 travelled a median of 161 minutes, almost identical to toddlers aged nought to four at 167 minutes. Whatever pushes a family toward distant treatment, it starts at diagnosis and holds steady through childhood.
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Distance does more than add hours to a journey. The study links longer travel with delays in diagnosis, gaps in treatment compliance, and strain on family finances and mental health.
“Long travel times do not only impose logistical difficulties on families,” the researchers wrote, pointing to evidence connecting distance with poorer outcomes and higher rates of families abandoning treatment altogether.
The study counted only children who reached one of the three hospitals. Those who could not make the journey at all fall outside its data, meaning the true scale of the barrier likely exceeds what the numbers show.
“The sample likely underrepresents the most disadvantaged populations who face substantial barriers to accessing care,” the authors wrote.
The study calls for paediatric cancer treatment to spread beyond a handful of major cities. It recommends building regional referral networks, expanding telemedicine, and funding transport and accommodation for families who must travel.
Akshithanand pointed to one model he sees as the fix for a country with limited resources.
“A decentralised care model would be an efficient intervention that can be adopted in a low resource country like India. Superspecialists at tertiary care facilities lead the diagnostics, disease staging, preparation of treatment plan, complex surgeries, and treatment initiation,” he said.
Under this model, the hospital stops being the only place where care happens.
“Continued treatment can be carried out at secondary healthcare facilities where maintenance chemotherapy, supportive care and palliative care are provided locally, with tele-consultation support from the primary treatment facility. This will help to support the continuation of care, support follow up, and limit the financial hardships the family has to endure,” Akshithanand said.
India has already begun some of this work. The government aims to open Day Care Cancer Centres in every district hospital by 2028, alongside 19 State Cancer Institutes and 20 Tertiary Care Cancer Centres now under construction.
“Addressing these geographic barriers through enhanced referral systems, transportation support, and targeted interventions for vulnerable populations will be essential to achieving equitable access to high-quality childhood cancer care services,” the authors concluded.
The study covers only three hospitals among the many that treat children with cancer across India, so it cannot capture every route a family takes. It also draws on friction-mapping data from 2019, a snapshot that may understate journeys made in earlier years, before certain roads existed.
Even so, the authors describe the work as the first of its scale in India to track individual patients rather than population averages, giving policymakers a base to measure change as new centres open.
(Edited by Fayisa CA)
