Location as Destiny: Identifying Geospatial Disparities in Radiation Treatment Interruption by Neighborhood, Race, and Insurance

Elsevier, International Journal of Radiation Oncology Biology Physics, Volume 107, 15 July 2020
Wakefield D.V., Carnell M., Dove A.P.H., Edmonston D.Y., Garner W.B., Hubler A. et al.
Purpose: Radiation therapy interruption (RTI) worsens cancer outcomes. Our purpose was to benchmark and map RTI across a region in the United States with known cancer outcome disparities. Methods and Materials: All radiation therapy (RT) treatments at our academic center were cataloged. Major RTI was defined as ≥5 unplanned RT appointment cancellations. Univariate and multivariable logistic and linear regression analyses identified associated factors. Major RTI was mapped by patient residence. A 2-sided P value <.0001 was="" considered="" statistically="" significant.="" results:="" between="" and="" a="" total="" of="" patients="" received="" rt="" whom="" were="" eligible="" for="" analysis:="" had="" interruptions="" major="" rti.="" disparities="" in="" rti="" seen="" across="" medicaid="" versus="" commercial="" insurance="" vs="" p="" low="" high="" predicted="" income="" black="" white="" race="" urban="" suburban="" treatment="" location="" on="" multivariable="" analysis="" increased="" odds="" ratio="" confidence="" interval="" those="" with="" head="" neck="" ci="" gynecologic="" lung="" cancers="" compared="" breast="" cancer.="" mapped="" to="" majority="" low-income="" neighborhoods="" rural="" regions.="" conclusions:="" radiation="" interruption="" disproportionately="" affects="" financially="" socially="" vulnerable="" patient="" populations="" maps="" high-poverty="" neighborhoods.="" geospatial="" mapping="" affords="" an="" opportunity="" correlate="" access="" neighborhood="" level="" inform="" potential="" intervention="" strategies.="">