Assessment of Parking Fees at National Cancer Institute–Designated Cancer Treatment Centers

The economic and personal distress resulting from the costs of cancer treatment has been referred to as financial toxicity. Nonmedical costs such as travel expenses are almost never reimbursed by insurance and can be a substantial out-of-pocket expense. This cross-sectional study aims to report parking fees at National Cancer Institute (NCI)–designated cancer treatment centers and to assess parking costs for the treatment duration of certain cancers.

Parking fees from the 63 NCI-designated cancer treatment centers were obtained via online search or telephone call from September 1, 2019, to December 30, 2019. City cost of living score (with New York City as the base city with a cost of living expressed as 100; costs for other cities were indexed against this number), median city household income (calculated in 2018 dollars), center address transit score (with 0-24 indicating minimal transit options and 90-100 indicating world-class public transportation), and discount availability were documented. A zero-inflated negative binomial model was used to assess associations between parking costs and city variables. Pearson correlation was used for binary variables (RStudio version 1.2.5033; RStudio PBC). Parking costs were estimated for treatment of node-positive breast cancer (12 daily rates plus twenty 1-hour rates), definitive head and neck cancer (thirty-five 1-hour rates), and acute myeloid leukemia (42 daily rates). Data were analyzed in March 2020.