ARRS 2022 Abstracts

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E1251. Accessibility of Accredited Breast, Lung, and Colorectal Imaging Cancer Screening Centers Among American Indian and Alaskan Native Tribes
Authors
  1. Miguel Pena; Department of Radiology, Massachusetts General Hospital
  2. Claudia Muns; University of Puerto Rico-Medical Sciences Campus
  3. Carlos Gonzalez Baerga; Universidad Central del Caribe
  4. Anirudh Sudarshan; The University of Texas at Austin
  5. Anand Narayan; Department of Radiology, University of Wisconsin-Madison
  6. Efren Flores; Department of Radiology, Massachusetts General Hospital
Objective:
American Indian and Alaskan Native (AI/AN) populations have nearly three times higher rates of lung and colorectal cancer incidence compared with other ethnic/racial groups. These patterns are strongly influenced by income, rurality, education, and transportation, placing them at a greater risk for adverse cancer-related outcomes. Cancer screening can bridge these gaps through early detection and accessible imaging cancer screening centers are critical for this patient population. However, accessibility to imaging cancer screening centers among AI/AN has not been well studied in the literature. Thus, the purpose of this study was to perform an analysis of geographic accessibility of accredited imaging cancer screening facilities among AI/AN populations.

Materials and Methods:
Using the Department of Interior’s Bureau of Indian Affairs website, we collected a list of federally recognized AI/AN tribes along with their respective zip codes via their official tribe website. For each tribe, we recorded the distance to their closest lung, breast, and colorectal cancer screening center and ACR accreditation status, and if the closest location was in or out of state. For colorectal and lung cancer screening, the ACR’s ‘My Computed Tomography Colonography (CTC) Screening Location Finder’ and ‘Lung Cancer Screening (LCS) Locator Tool’ were used to search screening centers up to a 200-mile radius from the AI/AN tribe’s zip code. For breast cancer screening, we used the FDA’s ‘Mammography Certified Facilities Database’ and the FreeMapTools engine to find each AI/AN tribe’s closest cancer center by zip code and match it with the FDA’s database.

Results:
A total of 594 federally recognized AI/AN tribes met inclusion criteria. For LCS, 76.4% (454/594) of AI/AN populations had their closest LCS center within 200 miles, with a mean distance of 43.6 miles (SD: 48.9 miles, range: 0.1–195 miles), 88.3% (401/454) of the nearest LCS centers were in-state, and only 26.9% (122/454) were ACR accredited. For CTC screening, 63.3% (376/594) of all AI/AN populations had a CTC center within 200 miles, with a mean distance of 79.8 miles (SD: 50.8, range: 0–190 miles), 70.21% (264) of the closest CTC centers were in-state, and 46.9% (177/377) were ACR accredited. For breast cancer screening, 93.7% (557/594) of populations had centers within 200 miles with a mean distance of 44.32 miles (SD= 51.9; range 0.2 -190 miles), 95.7% (533/557) were in-state and 65.5% (365/557) were ACR accredited.

Conclusion:
A significant proportion of AI/AN tribes do not have accessible, accredited centers for lung, breast, and colorectal cancer screening. Distance barriers may perpetuate existing disparities in cancer screening outcomes among AI/AN tribes who face multilevel barriers to care. Understanding barriers and increasing access to imaging cancer screening centers among AI/AN populations is vital to inform the development of programs to advance equity in cancer screening and improve outcomes among this patient population.