For the approximately 20% of rural Americans living more than 60 miles from a medical oncologist, the significant travel distances required for these often low-income patients to reach a cancer specialist should hasten policy action to improve access to specialized cancer care, according to results from a report published in Cancer.
Researchers used the 2018 Physician Compare data on physician practice locations and the 2012 to 2016 American Community Survey to estimate the driving distance from each residential zip code tabulation (ZCTA) centroid to the closest cancer clinician in colorectal and cervical cancer, specifically in the specialties of surgical oncology, gynecologic oncology, medical oncology, general surgery, colorectal surgery, and radiation oncology.
Analyses via multivariate logistic regression on the associations between ZCTA-level traits and driving distances in excess of 60 miles to each type of specialist revealed rural-urban differences in travel distance to the nearest oncology clinician(s) increased significantly for cancer surgeons. More than half of rural residents would have to drive more than 60 miles for care from a gynecologic oncologist vs 8 miles for their urban-dwelling counterparts.
People living within ZCTAs with higher rates of poverty, located in the South and West regions of the United States, and/or of American Indian/Alaska Native ethnicity were more likely to be more than 60 miles away from cancer clinicians.
“To mitigate potential negative consequences due to long travel distances, multifaceted community solutions have been proposed. Mobile cancer screening, telemedicine, and home-based early-stage chemotherapy are commonly proposed solutions to address travel barriers,” the authors noted.
They concluded, “State public health agencies, community health care facilities, and cancer care physicians, as well as other health care networks, could work together to target underserved and low-income populations and provide affordable travel options to repeated outpatient care for patients affected by cancer.”
Hung P, Deng S, Zahnd WE, et al. Geographic disparities in residential proximity to colorectal and cervical cancer care providers [published online November 8, 2019]. Cancer. doi: 10.1002/cncr.32594