1111 - Building a Scalable Radiation Oncology Access Database: Lessons from a Geospatial Analysis of Oregon
Presenter(s)
J. T. Butler1, P. Sanghvi2, and R. F. Thompson3,4; 1Oregon Health and Science University, Portland, OR, 2Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, 3Portland VA Healthcare System, Portland, OR, 4Department of Radiation Medicine, Oregon Health & Science University, Portland, OR
Purpose/Objective(s): The US lacks a comprehensive radiation oncology (RO) practice database capable of guiding clinical referrals and informing workforce and access-related policy. Existing studies of RO access are often limited to county-level summaries and do not integrate facility capability, workforce data, or travel-time metrics. As a result, significant geographic disparities remain obscured within seemingly adequate national averages. To address this gap, we performed an in-depth statewide geospatial analysis of Oregon as a proof-of-concept to develop a scalable framework for mapping RO access, population catchment, workforce distribution, and identify areas that may benefit from RO expansion.
Materials/Methods: This cross-sectional study that cataloged active RO centers (ROCs), radiation oncologists, linear accelerators, and modality-specific capabilities in Oregon using multiple datasets (NPPES, CMS, IROC, DIRAC) and direct verification. ROCs were geocoded and analyzed using ArcGIS (2025). US Census population surrounding ROCs was modeled using both distance and drive-time bands, with population catchment areas determined by shortest drive-times. County-level all-cancer mortality-to-incidence ratios (MIRs) were calculated using SEER 2018–2022 data and summarized by proximity to nearest ROC.
Results: In 2025, Oregon had 27 RO centers, 51 LINACs, and 87 RO physicians largely concentrated in the Portland Metro Area, with 16 out-of-state centers within 50 miles of the border. While 71% of residents live within 10 miles of care, 54% of land area lacks nearby services, leaving 434,855 individuals (10%) more than 60 minutes away from RO care, with a recent facility closure leaving ~110,000 people without in-state access. In some counties, patients rely on out-of-state facilities with drive-times exceeding 2.5 hours. Although at the state-level workforce and equipment ratios exceed national averages, ROC mapping revealed regions with limited RO access and worse all-cancer outcomes. Increasing geographic isolation from ROCs was ecologically associated with higher all-cancer mortality-to-incidence ratios. In sum data collected provides a much needed benchmark to characterize and compare other states.
Conclusion: This Oregon-based geospatial analysis creates a referral database to guide clinicians and provides an actionable framework for state policymakers to monitor population catchment areas, and workforce and infrastructural needs. Broader adoption of similar databases across other states could support rational cancer care expansion and transparent workforce assessment, and be championed by national RO societies to improve cancer care at the national level.