The impact of county-level radiation oncologist density on prostate cancer mortality in the United States

Association Between Geographic Access to Cancer Care and Receipt of Radiation Therapy for Rectal Cancer

“…6, 7, 9, 32 Aneja et al used the Area Resource File to examine geographic access to radiation oncologists. 6, 7 They reported that radiation oncologist density varies regionally and were inequitably distributed, being primarily located in metropolitan areas and being absent in 66% of 2472 counties or 44% of 949 Health Service Areas in the U.S. By using linked SEER-Medicare claims and the American Medical Association Masterfile, Baldwin et al reported that one fourth of colorectal cancer patients did not have radiation oncology services available within 30 miles of their residence. 9 Since radiation oncologists cannot deliver external beam RT without a linear accelerator, geographic distribution of facilities equipped with radiation delivery units can also provide insights into RT accessibility.…”

“…Higher population density of radiation oncologists is associated with increased likelihood of receiving RT 5 and improved treatment outcome. 6 Studies have demonstrated, however, that radiation oncologists are geographically maldistributed across the nation, 7, 8 clustered at academic centers 7 and of limited accessibility relative to other oncology specialists. 9 Traveling long distances to cancer care is a barrier to cancer treatment, 10–12 associated with decreased utilization of RT, 13–15 or worse treatment outcome.…”

Geographical Factors Associated with Health Disparities in Prostate Cancer

“…The geographical and prostate cancer factors found in selected disparity studies have been summarized in the Table. [12][13][14][15][16][17][18][19][20][21][22][23][24][25]…”

“…52 In the field of prostate cancer, research using GIS approaches has been conducted to investigate diagnoses, management, and treatment outcomes across different geographical levels, such as counties, census division/tracts, cancer registry areas, and other aggregate geographical scales. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68] Cockburn et al 53 used the GIS to geocode the historical residential addresses of individuals and measured the association between ambient exposure to pesticide and incidence rates of prostate cancer in California. They found a positive relationship between prostate cancer and ambient pesticide exposure in and around homes in intensely agricultural areas.…”

Quality assessment in prostate cancer centers certified by the German Cancer Society

“…Second, the dual infrastructure for medical specialists in Germany-that is, due to the two sectors of secondary care (hospitals, office-based physicians)-results in a substantial number of patients being seen by only one specialist without a connection to other experienced colleagues or to a certified PCC. The objective of the certification system is-among other issues-to provide a network of qualified partners that represents the entire chain of health care specialists for as many patients as possible and to evaluate the patients' disease and treatments in a multidisciplinary manner [17,18]. This does not mean that office-based colleagues shall refer their patients to hospitals, but that they become part of the network while keeping their role as the patient's gate keeper.…”