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Study: Long distances separate Native Americans from cancer treatment

TWO GREY HILLS, NEW MEXICO - DECEMBER 16: Empty roadway sits along a main road on December 16, 2021 in Two Grey Hills, New Mexico. The Covid-19 pandemic has restricted many activities and events in Native American communities throughout Arizona and New Mexico. (Photo by Spencer Platt/Getty Images)

PORTLAND, Ore. (KOIN) – Researchers at Washington State University found that many Native Americans have to travel especially large distances to access radiation therapy for cancer treatment. 

The study, which was recently published in the journal Value in Health, found that people living in neighborhoods in the U.S. with a majority of American Indian and Alaska Native populations have to travel around 40 miles farther to the nearest radiation therapy facility than those living in neighborhoods dominated by other racial groups. 

Native Americans also experience higher rates of certain cancers than non-Hispanic white populations. 

“Up to 60% of cancers require access to radiation therapy, which can be delivered only in specialized facilities by trained physicians,” said Solmaz Amiri, an author of the study. “Considering that treatment regimens require once or twice daily visits for up to eight weeks, getting to those facilities is a significant burden that becomes an important barrier to treatment.”

Because of this barrier, she said people seeking cancer treatment may choose more invasive surgeries, such as a mastectomy or full breast removal for breast cancer, instead of less-invasive surgeries that require follow-up radiation therapy treatment. 

To identify the disparities, Amiri and her coauthors used a database of addresses of radiation therapy facilities and calculated the distance to the closest facility for each block group, a geographic unit used by the U.S. Census Bureau that includes up to 3,000 people. They then used data from the 2019 American Community Survey to compare travel distances by the racial and ethnic composition, area deprivation and rurality of block groups.

They found that travel distances for block groups with an American Indian and Alaska Native majority ranged between 26 and 103 miles, compared to a range of 3 to 35 miles for block groups with other majority populations. 

The researchers also found three regions in the U.S. that they consider “radiation therapy deserts” with longer than average travel distances to radiation therapy. One is in the western U.S. and covers Oregon, Utah, Nevada and Arizona. The second is in the southern plains states of Colorado, Kansas, New Mexico and Oklahoma, and a third is in the northern plains states of Montana, North Dakota, South Dakota and Nebraska. 

The Washington State University study notes that almost a third of American Indian and Alaska Native people lived in these radiation therapy deserts. 

“We know that Native Americans have the worst outcomes once they are diagnosed with cancer, and one of the reasons they may not be getting optimal treatment may be related to treatment access,” Amiri said. “Very few of these multimillion-dollar buildings housing radiation therapy facilities are located in rural areas, and so they can’t serve all populations.” 

The research also showed disparities between rural and urban communities. Americans of any racial group living in small towns and rural areas have to travel about 30 miles more to receive radiation treatment compared to people living in urban areas. According to some estimates, more than half of all American Indians and Alaska Natives live in small towns and rural areas.  

Amiri suggested lawmakers consider the potential use of mobile radiation therapy facilities to help close access gaps, which could improve disparities in cancer outcomes and mortality in American Indian and Alaska Native communities.