Abstract
BACKGROUND: Hepatocellular carcinoma (HCC) remains a significant public health concern in South Korea even though the incidence rates are declining. While medical travel for cancer treatment is common, its patterns and influencing factors for patients with HCC are unknown. AIM: To assess medical travel patterns and determinants and their policy implications among patients with newly diagnosed HCC in South Korea. METHODS: This retrospective cohort study used the National Health Insurance Service database to identify patients with newly diagnosed HCC from 2013 to 2021. Medical travel was defined as receiving initial treatment outside one's residential region. Patient characteristics and regional trends were analyzed, and factors influencing medical travel were identified using logistic regression analysis. RESULTS: Among 64808 patients 52.4% received treatment in the capital. This proportion increased to 67.4% when including the surrounding metropolitan area. Medical travel was significantly more common among younger and wealthier patients. Patients with greater comorbidity burden or liver cirrhosis were less likely to travel. While geographic distance influenced travel patterns, high-volume academic centers in the capital attracted patients nationwide regardless of proximity. CONCLUSION: This nationwide study highlighted the centralization of HCC care in the capital. This observation indicates that regional cancer hubs should be strengthened and promoted for equitable healthcare access.