Value of Geographical Information Systems in Analyzing Geographic Accessibility to Inform Radiotherapy Planning: A Systematic Review

Abstract

PURPOSE Vulnerable populations face geographical barriers in accessing radiotherapy (RT) facilities, resulting in heterogeneity of care received and cancer burden faced. We aimed to explore the current use of Geographical Information Systems (GIS) in access to RT and use these findings to create sustainable solutions against barriers for access in low- and middle-income countries. MATERIALS AND METHODS A systematic review using the PRISMA search strategy was done for studies using GIS to explore outcomes among patients with cancer. Included studies were reviewed and classified into three umbrella categories of how GIS has been used in studying access to RT. RESULTS Forty articles were included in the final review. Thirty-eight articles were set in high-income countries and two in upper-middle–income countries. Included studies were published from 2000 to 2020, and were comprised of patients with all-cancers combined, breast, colon, skin, lung, prostate, ovarian, and rectal carcinoma patients. Studies were categorized under three groups on the basis of how they used GIS in their analyses: to describe geographic access to RT, to associate geographic access to RT with outcomes, and for RT planning. Most studies fell under multiple categories. CONCLUSION Although this field is relative nascent, there is a wide array of functions possible through GIS for RT planning, including identifying high-risk populations, improving access in high-need areas, and providing valuable information for future resource allocation. GIS should be incorporated in future studies, especially set in low- and middle-income countries, which evaluate access to RT.

Improving accessibility to radiotherapy services in Cali, Colombia: cross-sectional equity analyses using open data and big data travel times from 2020

“…Gaining knowledge on transport means used by patients and acting on factors in uencing accessibility beyond travel times. 41,80 For example, distributing subsidies that address social justice or organizing mobility services to promote health services accessibility, especially for outlying urban areas.…”

“…40 A systematic review assessing the use of geographical information systems for radiotherapy planning found no studies providing an equity perspective that considered tra c congestion in low or middle-income countries, part of a multistakeholder coalition, or following a participatory people-centred approach. 41 Transportation subsidies are increasingly available in Colombia to treat high-cost diseases like cancer. However, these subsidies can perpetuate inequities because they need to account for factors that de ne out-of-pocket and indirect costs, such as travel time or distance.…”

“…27,[42][43][44][45] Poor geographical accessibility to cancer treatments diminishes the quality of care and is associated with poor clinical outcomes. 38,41,[46][47][48][49][50] In this study, we aim to assess the impact of tra c congestion on the accessibility of radiotherapy services within urban Cali; explore the connections between sociodemographic factors in uencing health equity, tra c congestion patterns, and the accessibility of healthcare services; and predict the enhanced accessibility of radiotherapy services by strategically introducing facilities in 1-2 key locations. This predictive model is designed to optimise service accessibility and cater to the healthcare needs of Cali's diverse population.…”