Kim S, Kim N, Lee HS, Kim M, Kim H, Choi Y. Medical travel patterns for hepatocellular carcinoma treatment in South Korea: National Health Insurance data from 2013 to 2021. World J Gastrointest Oncol 2025; 17(9): 109060 [DOI: 10.4251/wjgo.v17.i9.109060]
Corresponding Author of This Article
Youngmin Choi, MD, PhD, Professor, Department of Radiation Oncology, College of Medicine, Dong-A University, Daesingongwon-ro 26, Seo-gu, Busan 49201, South Korea. cymin00@dau.ac.kr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Sep 15, 2025; 17(9): 109060 Published online Sep 15, 2025. doi: 10.4251/wjgo.v17.i9.109060
Medical travel patterns for hepatocellular carcinoma treatment in South Korea: National Health Insurance data from 2013 to 2021
Sungmin Kim, Naeun Kim, Hyung-Sik Lee, Mina Kim, Hoseob Kim, Youngmin Choi
Sungmin Kim, Youngmin Choi, Department of Radiation Oncology, College of Medicine, Dong-A University, Busan 49201, South Korea
Naeun Kim, Hyung-Sik Lee, Department of Radiation Oncology, Dong-A University Hospital, Busan 49201, South Korea
Mina Kim, Hoseob Kim, Department of Data Science, Hanmi Pharm. Co., Ltd, Seoul 05545, South Korea
Author contributions: Kim S and Choi Y developed the methodology and reviewed and edited the manuscript; Kim S prepared the original draft and acquired the funding; Kim S and Lee HS administered the project; Kim N and Kim H carried out the investigation and created the figures; Kim N and Kim M curated the data; Lee HS and Choi Y conceptualized the study; Kim M and Kim H managed the software and conducted the formal analysis; Kim M and Choi Y performed the validation; Choi Y provided the resources and supervised the project; all authors read and approved the final manuscript.
Supported by Dong-A University Research Fund, No. 20230598.
Institutional review board statement: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of Dong-A University Hospital, No. DAUHIRB-EXP-23-003.
Informed consent statement: Patient consent was waived due to the utilization of anonymous administrative data.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Youngmin Choi, MD, PhD, Professor, Department of Radiation Oncology, College of Medicine, Dong-A University, Daesingongwon-ro 26, Seo-gu, Busan 49201, South Korea. cymin00@dau.ac.kr
Received: April 30, 2025 Revised: June 7, 2025 Accepted: July 21, 2025 Published online: September 15, 2025 Processing time: 139 Days and 20.2 Hours
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.
Core Tip: This nationwide retrospective cohort study examined domestic medical travel patterns among patients newly diagnosed with hepatocellular carcinoma in South Korea. Despite universal health insurance and open provider access, over half of the patients with hepatocellular carcinoma traveled to the capital for initial treatment. Younger age, higher income, and residence in non-capital regions were key drivers of medical travel. These findings highlighted the persistent regional disparities and indicate that policy efforts to strengthen regional cancer centers should be made to ensure geographically equitable access to specialized care.
