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Nearly 15 million women have no access to GYN oncology care
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Each year in the U.S., over 9% of women who have gynecologic cancers face barriers to care due to distance, according to recently published data in Gynecologic Oncology.
“Based on our estimates, it’s likely that more than 7,000 women with gynecologic cancers per year experience distance-related barriers to accessing appropriate care from a specialist. Increased travel time to a specialty center likely prevents many patients from being appropriately evaluated, and may decrease their likelihood of receiving the standard of care, or accessing clinical trials for ovarian, uterine and cervical cancers,” David I. Shalowitz, MD, division of gynecological oncology, University of Pennsylvania, said in a press release.
To quantify the population of women who face geographic barriers to gynecologic oncology care, researchers evaluated geographic information systems from 3,143 counties in the U.S. to identify which areas are more than 50 miles from the closest gynecologic oncologist. Additionally, researchers identified which areas were in hospital referral regions that did not have the primary professional address of at least one gynecologic oncologist.
Results demonstrated that 36% of counties were more than 50 miles from the closest gynecologic oncologist, making these regions low-access counties (LACs). Approximately 14.8 million women (9.8%) in the U.S. currently live in LACs, according to study results.
Overall, while the majority of LACs were located in the Midwest and Mountain-West, 47 out of 50 states had at least one county at a distance more than 50 miles from the closest gynecologic oncologist. Women in these areas were more likely to be white, Hispanic or American Indian/Alaskan Native than black and have a lower household income, compared with women not living in LACs.
Across cancer rates in the U.S., 8.5% of ovarian cancer cases, 9.9% of uterine cancer cases and 9.3% of cervical cancer cases were located in LACs.
Nationally, over 40% of hospital referral regions, with approximately 23.5 million women residing in these areas, did not contain the primary address of a gynecologic oncologist.
The researchers noted that to ensure care to more women with gynecologic malignancies, all LACs should be staffed with a gynecologic oncologist, and actions should be taken with referral structures to reduce travel burdens on patients.
“In the United States, 9 to 15% of women live in areas that may limit their access to high-quality care for gynecologic cancers. Equitable cancer care delivery requires identification and minimization of health disparities, including those related to the geographic distribution of patients’ residences and access points to subspecialty care. The next step is to define those areas with poor clinical outcomes attributable to geographic factors,” Shalowitz and colleagues wrote. – by Casey Hower
Disclosure: The researchers report no relevant financial disclosures.
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