June 17, 2015 — Nearly 15 million women in the U.S. live more than 50 miles from a gynecologic oncologist, according to a study published last week in Gynecologic Oncology, HealthDay/U.S. News & World Report reports.
Researchers found that about 36% of counties in the U.S. are more than 50 miles away from a physician who specializes in cervical, ovarian and uterine cancer, with the majority of such counties located in the Midwest and Mountain-West regions. Overall, the study found that roughly 10% of U.S. women reside in one of the lower-access counties.
According to the researchers, 47 states have at least one county with low access to gynecologic cancer specialists. They noted women in North Dakota face particular difficulties because the state is more than 50 miles away from a physician specializing in gynecologic oncology. Meanwhile, the counties where gynecologic cancer care is most easily accessible tend to be near larger U.S. cities, especially in the coastal area between Atlanta and Boston.
Further, the researchers found that 15% of U.S. women could face difficulties accessing such care because of their insurance plans. Specifically, the researchers said 123 insurance referral networks in the U.S. do not include a gynecologic cancer specialist, meaning that women in those plans would have to find out-of-network care.
Study author David Shalowitz, a fellow in the University of Pennsylvania School of Medicine's division of gynecologic oncology, said, "This is the first national study to identify specific regions of the United States where residents may be at an increased risk for poor clinical outcomes -- including misdiagnoses and late detection -- as a result of limited access to specialized gynecologic cancer care."
Specifically, he said the study estimated that "more than 7,000 women with gynecologic cancers per year experience distance-related barriers to accessing appropriate care from a specialist." According to Shalowitz, longer distances and increased travel time could stop patients from being adequately evaluated and reduce their chances of receiving standard care or participating in clinical trials.
In reference to insurer networks, Shalowitz said, "While we don't yet know how access correlates to health outcomes, referral networks need to be structured in a way that alleviates the burden of travel for women in need of a specialist" (Preidt, HealthDay/U.S. News & World Report, 6/15).