A. G. Gouveia1, D. DelRosso2, G. Viani3, M. F. Silva4, A. A. Rosa5, G. N. Marta6, M. S. Castilho7, T. Tsakiridis8, M. T. M. Starling9, C. F. P. M. de Sousa6, S. A. Hanna6, and F. Y. Y. Moraes10; 1McMaster University, Hamilton, Canada, 2McMaster University, Hamilton, ON, Canada, 3Faculdade de Medicina de Ribeirao Preto - USP, Ribeirão Preto, Brazil, 4Santa Maria Federal University, Rio Grande do Sul, Brazil, 5Hospital Santa Izabel, Salvador, Brazil, 6Department of Radiation Oncology, Hospital Sírio-Libanês, Sao Paulo, Brazil, 7Radiotherapy Department of the Felicio Rocho Hospital, Belo Horizonte, Brazil, 8Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada, 9Hospital BP, Sao Paulo, Sao Paulo, Brazil, 10Queen’s University, Kingston, ON, Canada., Kingston, ON, Canada
Purpose/Objective(s):This observational study evaluates disparities in access to radiotherapy in Brazil, focusing on the distances traveled by patients for treatment. Utilizing official data from 2017 to 2022, it aims to quantify the geographical challenges faced by individuals seeking radiotherapy. Materials/
Methods: Data from the national Outpatient Procedure Authorization (APAC) system were collected as .dbc files and processed using Python. Variables included procedure type, procedure year, patient demographics (gender, race), patients city of residence, treatment state and region, and whether treatment was sought in another city. Distances between patients residences and treatment facilities were calculated using the Haversine formula and analyzed in kilometers. This data was incorporated into a Power BI database for analysis. Statistical significance was assessed using T-tests and ANOVA, with a threshold of p < 0.05. Results: Out of 840,779 radiotherapy procedures analyzed, 514,237 required travel to another city, excluding 326,542 conducted within the patients city. The national average distance for accessing radiotherapy was 120.1 km, with no significant year-on-year change (p=0.993). Regional disparities were evident: 442.2 km in the North, 238.9 km in the Midwest, 161.8 km in the Northeast, 73.8 km in the Southeast, and 71.3 km in the South (p<0.001). Gender and race influenced travel distances; females traveled an average of 122.3 km and males 117.3 km (p < 0.05); white patients traveled 97.3 km on average, whereas non-white patients averaged 145.6 km (p < 0.001). Distance varied by procedure type: curative (114.1 km), palliative (116.3 km), benign disease radiation (80.6 km), and complex procedures (165.8 km), p < 0.001. Conclusion: Significant geographical disparities affect access to radiotherapy in Brazil, particularly for residents of underdeveloped areas, women, and non-white patients. These findings highlight the need for strategic improvements in healthcare infrastructure and accessibility.
