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

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.="">