Abstract PO-174: Using GIS mapping to explore factors in Texas' disparities in access to cancer care
Authors: Nmadu Yeka W. , Dahlke Deborah V. , Horel Scott A. , Ory Marcia G. , Ramos Kenneth S. 
Published: January 2022

Abstract
Introduction: The significant decline in cancer incidence and mortality over the last two decades in the United States is likely the result of reductions in tobacco use, increased uptake of preventive methods, adoption of early screening methods and improved treatment options. Texas, due to its large size and significant rural and heterogeneous populations, continues to experience disparities in cancer incidence and access to care and clinical trials. This study aimed to: 1) assess cancer incidence in Texas for three target indications compared to national data, and 2) analyze potential disparities in access to care with respect to the locations of American College of Surgeons Accredited (ACoS) Cancer Centers and National Cancer Institute (NCI) Cancer Centers within Texas' 11 Public Health Regions (PHR). Methods: We used data from the Texas Cancer Registry and compared age-adjusted incidence for our three target indications (adult colon cancer in patients under 50 years of age, advanced cervical cancer, and advanced liver cancer) in the 11 PHR and the defined Border Region of Texas with national data from the US Surveillance, Epidemiology, and End Results Program (SEER). We used GIS mapping to locate the cancer centers in Texas' PHR. Results: Initial results indicate that all 11 Texas' PHR ranked higher than national averages for age-adjusted incidence of cervical and liver cancer. Further, incidence rates for adolescents and young adult colorectal cancer are above SEER average in the majority of the PHR located in the northern and eastern regions of the state. When compared with Texas incidence rates, PHR 1 (Lubbock) and PHR 11 (Harlingen) have higher incidence rates for all three indications. Two PHR in the Border region (PHR 10: El Paso and 11: Harlingen) have Texas' highest incidence of liver cancer. The distribution of ACoS centers appears concentrated in eastern Texas, with highest numbers in PHR 3 (Dallas area) and PHR 6 (Houston area); with three of the four NCI-designated cancer centers in Texas are located in these two regions. Lower rates of cancer incidence for all three cancer indications were found in PHR regions 3 and 6. Among the Border counties, Cameron, Maverick and Star counties ranked above the Texas' average for all three cancer indications. There is an apparent paucity of cancer centers in the Border Region with only three centers identified in the 32 counties within the region. Conclusion: Texas statewide ranked above SEER's averages in two of the three cancer indications-cervical and liver cancers. There are clear regional differences in incidence of cervical, liver, and colorectal cancer which suggest disparities in access to care. Future research will draw on these findings to assess distance to cancer centers and clinical trial locations for Texas patients in our three targeted cancers and determine if broadband coverage is associated with disparities in cancer rates.
Citation Format: Yeka W. Nmadu, Deborah V. Dahlke, Scott A. Horel, Marcia G. Ory, Kenneth S. Ramos. Using GIS mapping to explore factors in Texas' disparities in access to cancer care [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-174.