Division of Radiation Oncology, The Ottawa Hospital and the University of Ottawa, Canada; Department of Radiation Oncology, Amsterdam UMC - Vrije University Medical Center, Amsterdam, The Netherlands.
Department of Clinical Oncology, Rigshospitalet, Copenhagen, Denmark.
Radiother Oncol. 2020 May;146:1-8. doi: 10.1016/j.radonc.2020.01.023. Epub 2020 Feb 14.
A high cancer burden exists among indigenous populations worldwide. Canada and Greenland have similar geographic features that make health service delivery challenging. We sought to describe geographic access to radiotherapy for indigenous populations in both regions.
We used geospatial analyses to calculate distance and travel-time from indigenous communities in Canada and Greenland to the nearest radiotherapy center. We calculated the proportion of indigenous communities and populations residing within a 1 and 2-hour drive of a radiotherapy center in Canada, and compared the proportion of indigenous versus non-indigenous populations residing within each drive-time area. We calculated the potential distance and travel-time saved if radiotherapy was available in northern Canada (Yellowknife and Iqaluit), and Greenland (Nuuk).
Median one-way travel from indigenous communities to nearest radiotherapy center in Canada was 268 km (3 h when considering any transportation mode), and 4111 km (6 h by plane) in Greenland. In Canada, 84% and 68% of indigenous communities were outside a 1 and 2-hour drive from a radiotherapy center, respectively. Only 2% of the total population in Canada resided outside a 2-hour drive from a radiotherapy center. However, indigenous peoples were 336 times more likely to live more than a 2-hour drive away, compared to non-indigenous peoples. Nearly 3 million km and 4000 h of travel could be saved over a 10-year period for patients with newly diagnosed cancers in Canada, and 7 million km and 10,000 h in Greenland, if radiotherapy was available in Yellowknife, Iqaluit and Nuuk.
Geography is an important barrier to accessing radiotherapy for indigenous populations in Canada and Greenland. A significant disparity exists between indigenous and non-indigenous peoples in Canada. Geospatial analyses can help highlight disparities in access to inform radiotherapy service planning.
全世界的原住民群体都面临着沉重的癌症负担。加拿大和格陵兰具有相似的地理特征，这使得医疗服务的提供具有挑战性。我们旨在描述这两个地区原住民群体接受放射治疗的地理可达性。
我们使用地理空间分析来计算加拿大和格陵兰的原住民社区与最近的放射治疗中心之间的距离和旅行时间。我们计算了居住在加拿大的放射治疗中心 1 小时和 2 小时车程内的原住民社区和人口比例，并比较了居住在每个车程区域内的原住民和非原住民人口比例。我们计算了如果在加拿大北部（黄刀市和伊魁特市）和格陵兰（努克）提供放射治疗，可以节省的潜在距离和旅行时间。
加拿大原住民社区到最近放射治疗中心的单向旅行中位数为 268 公里（考虑到任何交通方式，需要 3 小时），而在格陵兰为 4111 公里（乘飞机需要 6 小时）。在加拿大，84%和 68%的原住民社区分别距离放射治疗中心超过 1 小时和 2 小时车程。只有 2%的加拿大总人口居住在距离放射治疗中心 2 小时车程以外的地方。然而，与非原住民相比，原住民居住在距离放射治疗中心 2 小时车程以上的可能性要高出 336 倍。如果在黄刀市、伊魁特市和努克提供放射治疗，在加拿大，10 年内可节省近 300 万千米和 4000 小时的旅行时间，在格陵兰则可节省 700 万千米和 10000 小时的旅行时间。
地理因素是加拿大和格陵兰原住民获得放射治疗的重要障碍。加拿大的原住民和非原住民之间存在显著差异。地理空间分析可以帮助突出获取放射治疗服务方面的差异，为放射治疗服务规划提供信息。
