Gaps in cancer center catchment area coverage may fuel disparities
Geographic gaps in cancer center catchment area coverage may be propagating disparities in cancer incidence and mortality, according to results of a study published in Cancer Epidemiology, Biomarkers and Prevention.
Leaders of cancer centers should prioritize efforts to ensure coverage to all, researchers wrote.
"Geographical gaps in catchment area coverage are similar to the known geographical areas where cancer disparities persist,” Amy E. Leader, DrPH, MPH, associate professor of population science and medical oncology and associate director of community integration at Sidney Kimmel Cancer Center, and Christopher McNair, PhD, associate director for data science, director of cancer informatics, and assistant professor in the department of cancer biology at Thomas Jefferson University, said in a joint statement to Healio.
Background
Typically, a cancer center’s catchment center is “where the majority of [patients with cancer] treated by a center reside, where research participants live, the boundaries of a cancer center or hospital’s marketing approach, or a combination of these,” the researchers wrote.
“For almost 10 years, cancer centers have been required to define and care for the populations in their catchment area,” Leader and McNair told Healio. “However, this data has remained siloed, so no studies have provided a comprehensive view of cancer center catchment areas.”
Leader, McNair and colleagues conducted what they called the first known geographic analysis and interpretation of primary catchment areas of all U.S.-based cancer centers and identified key geographic gaps to target for disparities reduction.
Methodology
The researchers surveyed all members of the Association of American Cancer Institutes, which included 102 cancer centers, to record and map each of their primary catchment areas and aggregated area descriptions by county.
They calculated catchment area coverage scores for each county and generated choropleths representing coverage across the U.S. The investigators then performed similar analyses to compare U.S. population density, cancer incidence and cancer mortality with each county’s cancer center catchment area coverage.
Key findings
Results showed 85% of U.S. counties fell into at least one cancer center’s primary catchment center. That left about 25 million Americans who resided outside of catchment areas.
Additionally, researchers found geographic trends in both overcoverage and undercoverage when they integrated catchment area coverage with population density, cancer incidence and cancer mortality metrics.
“While we expected to find areas of undercoverage, it is interesting that there are also areas of the country that are overresourced related to cancer center catchment areas. Discussions about catchment area alignment to be equitable across the country are warranted,” Leader and McNair told Healio.
Next steps
Investigators suggested realigning catchment areas — ensuring that every American resides in a cancer center’s primary catchment area — to help fill the gaps in coverage.
“Future research should continue to monitor the footprints of cancer center catchment areas and document changes in these, as cancer centers adjust their coverage to progress toward catchment-area equity,” Leader and McNair told Healio. “Understanding the priorities of cancer centers within their catchment areas, particularly as they relate to reducing cancer disparities, will be important to assessing the impact of catchment areas on the cancer burden in the U.S.”
For more information:
Amy E. Leader, DrPH, MPH, can be reached at Sidney Kimmel Cancer Center, Thomas Jefferson University, 834 Chestnut St., Suite 314, Philadelphia, PA 19107; email: amy.leader@jefferson.edu.
Christopher McNair, PhD, can be reached at Thomas Jefferson University, Bluemle Life Sciences Building, 504, 233 S. 10th St., Philadelphia, PA 19107; email: christopher.mcnair@jefferson.edu.
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