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Native Americans, nonurban residents, and people living in the South travel further for specialized cancer care
More than 42 percent of the U.S. population lives within 1 hour of a National Cancer Institute (NCI)-designated cancer center, and nearly 70 percent of the population lives within 1 hour of a cancer center or an academic medical center. If oncologists are included, 92 percent of the U.S. population is within 1 hour of any form of specialized cancer care. However, Native Americans, people living outside urban areas, and people residing in southern States have less access to specialized cancer care than other groups, according to a new study.
Researchers used the median driving time from the most populous region of each U.S. zip code to an NCI cancer center, an academic medical center, or an oncology practice, as measures of access by population subgroups to the three levels of specialized cancer care. Previous studies had shown that patients with a greater travel time for care were more likely to be diagnosed with advanced cancer, have decreased use of breast-conserving therapy, and have lower enrollment in clinical trials.
The researchers found that Native Americans, nonurban dwellers, and persons residing in southern States had the longest travel times to the nearest NCI cancer center, compared with the overall U.S. population. Native Americans and nonurban dwellers also had longer drive times to the nearest academic medical center or oncology practice.
The study found that the median travel time for the total continental U.S. population to an NCI cancer center was 78 minutes. Asians had the shortest median travel time (28 minutes), and Native Americans had the longest (155 minutes). Hispanics and whites had comparable travel times to these cancer centers (86 minutes for both groups), while blacks had a shorter median travel time of 69 minutes.
On a regional basis, compared with residents of the Northeast, the median travel time to an NCI cancer center was five times longer for people in the South, three times longer for residents of the Western States, and more than twice as long for residents of the Midwest. Travel times to all three cancer care settings was longest for Native Americans than other racial or ethnic groups and for nonurban than urban residents. The study was funded in part by the Agency for Healthcare Research and Quality (T32 HS00070).
More details are in "Geographic access to cancer care in the U.S.," by Tracy Onega, Ph.D., Eric J. Duell, Ph.D., M.S., Xun Shi, Ph.D., and others, in the February 15, 2008, Cancer 112(4), pp. 909-918.
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