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Delineation of Cancer Service Areas Anchored by Major Cancer Centers in the United States
Defining a reliable geographic unit pertaining to cancer care is essential in its assessment, planning, and management. This study aims to delineate and characterize the cancer service areas (CSA) accounting for the presence of major cancer centers in the United States. We used the Medicare enrollme...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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American Association for Cancer Research
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981203/ https://www.ncbi.nlm.nih.gov/pubmed/36875712 http://dx.doi.org/10.1158/2767-9764.CRC-22-0099 |
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author | Wang, Changzhen Wang, Fahui Onega, Tracy |
author_facet | Wang, Changzhen Wang, Fahui Onega, Tracy |
author_sort | Wang, Changzhen |
collection | PubMed |
description | Defining a reliable geographic unit pertaining to cancer care is essential in its assessment, planning, and management. This study aims to delineate and characterize the cancer service areas (CSA) accounting for the presence of major cancer centers in the United States. We used the Medicare enrollment and claims from January 1, 2014 to September 30, 2015 to build a spatial network from patients with cancer to cancer care facilities that provided inpatient and outpatient care of cancer-directed surgery, chemotherapy, and radiation. After excluding those without clinical care or outside of the United States, we identified 94 NCI-designated and other academic cancer centers from the members of the Association of American Cancer Institutes. By explicitly incorporating existing specialized cancer referral centers, we refined the spatially constrained Leiden method that accounted for spatial adjacency and other constraints to delineate coherent CSAs within which the service volumes were maximal but minimal between them. The derived 110 CSAs had a high mean localization index (LI; 0.83) with a narrow variability (SD = 0.10). The variation of LI across the CSAs was positively associated with population, median household income, and area size, and negatively with travel time. Averagely, patients traveled less and were more likely to receive cancer care within the CSAs anchored by cancer centers than their counterparts without cancer centers. We concluded that CSAs are effective in capturing the local cancer care markets in the United States. They can be used as reliable units for studying cancer care and informing more evidence-based policy. SIGNIFICANCE: Using the most refined network community detection method, we can delineate CSAs in a more robust, systematic, and empirical manner that incorporates existing specialized cancer referral centers. The CSAs can be used as a reliable unit for studying cancer care and informing more evidence-based policy in the United States. The cross-walk tabulation of ZIP code areas, CSAs, and related programs for CSAs delineation are disseminated for public access. |
format | Online Article Text |
id | pubmed-9981203 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | American Association for Cancer Research |
record_format | MEDLINE/PubMed |
spelling | pubmed-99812032023-03-03 Delineation of Cancer Service Areas Anchored by Major Cancer Centers in the United States Wang, Changzhen Wang, Fahui Onega, Tracy Cancer Res Commun Research Article Defining a reliable geographic unit pertaining to cancer care is essential in its assessment, planning, and management. This study aims to delineate and characterize the cancer service areas (CSA) accounting for the presence of major cancer centers in the United States. We used the Medicare enrollment and claims from January 1, 2014 to September 30, 2015 to build a spatial network from patients with cancer to cancer care facilities that provided inpatient and outpatient care of cancer-directed surgery, chemotherapy, and radiation. After excluding those without clinical care or outside of the United States, we identified 94 NCI-designated and other academic cancer centers from the members of the Association of American Cancer Institutes. By explicitly incorporating existing specialized cancer referral centers, we refined the spatially constrained Leiden method that accounted for spatial adjacency and other constraints to delineate coherent CSAs within which the service volumes were maximal but minimal between them. The derived 110 CSAs had a high mean localization index (LI; 0.83) with a narrow variability (SD = 0.10). The variation of LI across the CSAs was positively associated with population, median household income, and area size, and negatively with travel time. Averagely, patients traveled less and were more likely to receive cancer care within the CSAs anchored by cancer centers than their counterparts without cancer centers. We concluded that CSAs are effective in capturing the local cancer care markets in the United States. They can be used as reliable units for studying cancer care and informing more evidence-based policy. SIGNIFICANCE: Using the most refined network community detection method, we can delineate CSAs in a more robust, systematic, and empirical manner that incorporates existing specialized cancer referral centers. The CSAs can be used as a reliable unit for studying cancer care and informing more evidence-based policy in the United States. The cross-walk tabulation of ZIP code areas, CSAs, and related programs for CSAs delineation are disseminated for public access. American Association for Cancer Research 2022-05-24 /pmc/articles/PMC9981203/ /pubmed/36875712 http://dx.doi.org/10.1158/2767-9764.CRC-22-0099 Text en © 2022 The Authors; Published by the American Association for Cancer Research https://creativecommons.org/licenses/by/4.0/This open access article is distributed under the Creative Commons Attribution 4.0 International (CC BY 4.0) license. |
spellingShingle | Research Article Wang, Changzhen Wang, Fahui Onega, Tracy Delineation of Cancer Service Areas Anchored by Major Cancer Centers in the United States |
title | Delineation of Cancer Service Areas Anchored by Major Cancer Centers in the United States |
title_full | Delineation of Cancer Service Areas Anchored by Major Cancer Centers in the United States |
title_fullStr | Delineation of Cancer Service Areas Anchored by Major Cancer Centers in the United States |
title_full_unstemmed | Delineation of Cancer Service Areas Anchored by Major Cancer Centers in the United States |
title_short | Delineation of Cancer Service Areas Anchored by Major Cancer Centers in the United States |
title_sort | delineation of cancer service areas anchored by major cancer centers in the united states |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981203/ https://www.ncbi.nlm.nih.gov/pubmed/36875712 http://dx.doi.org/10.1158/2767-9764.CRC-22-0099 |
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