Abstract A014: An analysis comparing the geographic distribution of community cancer center providers to CRC prevalence rates among Medicare beneficiaries
Authors: DeSalvo Solarte Michael , De Lucas Sacristan Beatriz , Boehmer Leigh , Fashoyin-Aje Lola , Hobbs Kristin 
Published: January 2023

Colorectal cancer (CRC) has the fourth highest death rate among patients diagnosed with cancer in the United States. More than half of incidence occurs in the Medicare-eligible population; Data shows higher rates of incidence of CRC among the Black population compared to other races/ethnicities. More than 80% of cancer care is delivered in community outpatient settings. The Association of Community Cancer Centers (ACCC), a member community of more than 28,000 multidisciplinary practitioners and 2,100 cancer programs and practices nationwide, estimates that its members treat about 65% of the nation's cancer patients. Data have shown that a lack of access to cancer treatment may contribute to inferior clinical outcomes among certain demographic populations. Understanding proximity to community cancer care is critical to improve outcomes and reduce disparities. Research question: What is the geographic relationship between ACCC members relative to Medicare Fee-for-Service (MCR-FFS) beneficiaries living with CRC? Methods The authors examined CRC claims in MCR-FFS relative to ACCC member locations, using claims data from the 2019 Medicare Beneficiary Summary (MBSF) file for CRC. Records included were for beneficiaries with “at least 1 inpatient/SNF claim or 2 HOP/carrier claims with DX codes” for any diagnosis of CRC, irrespective of stage (“qualified CRC claims”). Only zip codes showing 11 or greater beneficiaries with qualified CRC claims (“eligible zip codes”) were included due to data suppression. The ACCC member database was queried to obtain geocoded member locations. The Colorectal Cancer Index™ was used to map the data from both sources. Prevalence estimates are considered point prevalence: a numerator shows a count of beneficiaries with qualified CRC claims over a denominator of all beneficiaries in the selected geography, expressed as a percentage. CMS standard demographic definitions are used for race/ethnicity: Asian, Black, Hispanic, North American Native, White, and Other. Preliminary Findings A total of 382,295 MCR-FFS beneficiaries with CRC were identified, residing in 10,280 zip codes; 56,062 people of color (POC) reside in 1,247 eligible zip codes.A total of 663 ACCC member providers were identified. The CRC prevalence (mean average) across the 10,280 eligible zip codes was 0.98%; Prevalence in 5,826 zip codes exceeded 0.98%. The CRC prevalence (mean average) across the 1,247 POC-eligible zip codes was 0.76%; Prevalence in 941 eligible zip codes exceeded 0.76%. ACCC members are located in 663 of all 10,280 eligible zip codes (6.4%) 251 ACCC members serve the 5,826 high prevalence eligible zip codes (4.3%). 72 ACCC members are located in the 941 eligible zip codes of high prevalence among CRC patients of color (7.5%) Conclusions Regions of high CRC prevalence appear to be potentially underserved by cancer programs in terms of direct geographic proximity. Additional analysis is ongoing to understand the significance of these findings as they relate to navigating MCR-FFS beneficiaries to timely diagnosis and care.

Citation Format: Michael DeSalvo Solarte, Beatriz De Lucas Sacristan, Leigh Boehmer, Lola Fashoyin-Aje, Kristin Hobbs. An analysis comparing the geographic distribution of community cancer center providers to CRC prevalence rates among Medicare beneficiaries [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A014.