GEOGRAPHIC INFORMATION SYSTEM FOR EVALUATION OF THE ACCESSIBILITY OF CANCER PATIENTS TO RADIOTHERAPY SERVICES
Main Article Content
Abstract
This study examines the issue of geographical accessibility to radiotherapy services within the Brazilian Unified Health System (SUS), focusing on patients diagnosed with breast and prostate cancer in the state of Rio de Janeiro. The main objective of the research was to develop a prototype of a georeferencing information system for radiotherapy services (Prototype-GeoRT) to evaluate the distances traveled in a straight line by patients from their homes to two high-complexity oncology reference units of the SUS. The research highlights the importance of geographical accessibility in patients' survival and quality of life, proposing the development of the Prototype-GeoRT as a fundamental tool to support public policies and promote equity in access to oncology services. Using a quantitative exploratory approach, the study analyses data from a cohort of patients who were initially diagnosed with breast and prostate cancer and treated between 2012 and 2022 in radiotherapy services at SUS units. The results highlight the need for policies considering the geographical redistribution of infrastructure resources and the relocation of the target population, providing strategic information on travel distances and population distribution. The importance of a more detailed analysis of correlations between other variables and the need for additional research to improve the model developed and proposed for the prototype is highlighted to support decision-makers in public health in Brazil.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c). Conjuncture Bulletin (BOCA)
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
AMBROGGI, M. et al. “Distance as a Barrier to Cancer Diagnosis and Treatment: Review of the Literature”. The Oncologist, vol. 20, n. 12, 2015.
ATUN, R. et al. “Expanding Global Access to Radiotherapy. The Lancet, vol. 16, n. 10, 2015.
BEJLERI, I. et al. “Exploring transportation networks relationship to healthcare access and as affected by urban sprawl”. Transportation Research Procedia, World Conference on Transport Research. Shanghai: WCTR, 2016.
BOSCOE, F. P. et al. “Geographic Proximity to Treatment for Early Stage Breast Cancer and Likelihood of Mastectomy”. The Breast, vol. 20, n. 4, 2011.
BRASIL. Lei n. 8.080, de 19 de Setembro de 1990. Brasília: Planalto, 1990. Disponível em: . Acesso em: 29/12/2023.
BRASIL. Lei n. 13.709, 14 de agosto de 2018. Brasília: Planalto, 2018. Disponível em: . Acesso em: 03/01/2024.
CARLOS, C. A. L. V. et al. Recusa pelo tratamento oncológico fora do município de residência: análise da região imediata de viçosa. Boletim de Conjuntura (BOCA), vol. 14, n. 41, 2023.
CHAN, J. et al. “Examining Geographic Accessibility to Radiotherapy in Canada and Greenland for Indigenous Populations: Measuring Inequities to Inform Solutions”. Radiotherapy and Oncology, vol. 146, 2020.
DATASUS - Departamento de Informática do SUS. “TabNet”. DATASUS [2023]. Disponível em: . Acesso em: 25/11/2023.
ENSOR, T. “Overcoming Barriers to Health Service Access: Influencing the Demand Side”. Health Policy and Planning, vol. 19, n. 2, 2004.
FONSECA, B. P. et al. “Geographic accessibility to cancer treatment in Brazil: A network analysis”. The Lancet Regional Health - Americas, vol. 7, 2022.
GOUVEIA, A. G. et al. “Challenges in building radiotherapy capacity: A longitudinal study evaluating eight years of the Brazilian radiotherapy expansion plan”. Journal of Cancer Policy, vol. 39, 2024
HAN, L. et al. “The impact of transportation mode, socioeconomic deprivation and rurality on travel times to radiotherapy and surgical services for patients with prostate cancer: a national population-based evaluation”. Radiotherapy and Oncology, vol. 192, 2024.
HANDE, V. et al. “Value of Geographical Information Systems in Analyzing Geographic Accessibility to Inform Radiotherapy Planning: A Systematic Review“. JCO - Global Oncology, vol. 8, 2022.
HERB, J. N. et al. “Travel Time to Radiation Oncology Facilities in the United States and the Influence of Certificate of Need Policies”. International Journal of Radiation Oncology, Biology, Physics, vol. 109, n. 2, 2021.
IARC - International Agency for Research on Cancer. “Cancer Tomorrow: A tool that predicts the future cancer incidence and mortality burden worldwide from the current estimates in 2020 up until 2040”. IARC [2023]. Disponível em: . Acesso em: 05/12/2023.
INCA - Instituto Nacional do Câncer. “Estimativa 2023: incidência de câncer no Brasil”. INCA [2023]. Disponível em: . Acesso em: 17/12/2023.
KELLY, C. et al. “Are Differences in Travel Time or Distance to Healthcare for Adults in Global North Countries Associated with an Impact on Health Outcomes? A Systematic Review”. BMJ Open, vol. 6, n. 11, 2016.
LASKAR, S. G. et al. “Access to Radiation Therapy: From Local to Global and Equality to Equity”. JCO – Global Oncology, vol. 8, 2022.
LIU, E. et al. “A Quantitative Analysis of the Relationship between Radiation Therapy Use and Travel Time”. International Journal of Radiation Oncology Biology Physics, vol. 93, n. 3, 2015.
MAKANGA, P. T. et al. “Seasonal Variation in Geographical Access to Maternal Health Services in Regions of Southern Mozambique”. International Journal of Health Geographics, vol. 16, n. 1, 2017.
MAROONGROGE, S. et al. “Geographic Access to Radiation Therapy Facilities in the United States”. International Journal of Radiation Oncology, Biology, Physics, vol. 112, n. 3, 2022.
NATTINGER, A. B. et al. “Relationship of Distance From a Radiotherapy Facility and Initial Breast Cancer Treatment”. Journal of the National Cancer Institute, vol. 93, n. 17, 2001.
O’CONNELL, T. S. et al. “Synthesizing Qualitative and Quantitative Evidence on Non-Financial Access Barriers: Implications for Assessment at the District Level”. International Journal for Equity in Health, vol. 14, n. 1, 2015.
ONITILO, A. A. et al. “Geographical and Seasonal Barriers to Mammography Services and Breast Cancer Stage at Diagnosis”. Rural and Remote Health, vol. 14, n. 3, 2014.
RIPPY, E. E. et al. “Influences on Decision for Mastectomy in Patients Eligible for Breast Conserving Surgery”. The Breast, vol. 23, n. 3, 2014.
ROSERO-BIXBY, L. “Spatial Access to Health Care in Costa Rica and Its Equity: A GIS-Based Study”. Social Science and Medicine, vol. 58, n. 7, 2004.
SBRT - Sociedade Brasileira de Radioterapia. “RT 2020-2023. Plano de desenvolvimento da radioterapia para a próxima década”. SBRT [2023]. Disponível em: . Acesso em: 10/11/2023.
SILVA, C. R. D. et al. “Conceito de saúde digital na Atenção Primária à Saúde (2020-2022): Um estudo baseado no método evolucionário de Rodger”. Boletim de Conjuntura (BOCA), vol. 17, n. 49, 2024.
STOYANOV, D. S. et al. “Impact of Travel Burden on Clinical Outcomes in Lung Cancer”. Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, vol. 30, n. 6, 2022.
THOMAS, A. A. et al. “Distance from Treating Hospital and Colorectal Cancer Survivors’ Quality of Life: A Gendered Analysis”. Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, vol. 23, n. 3, 2015.
TORRE, L. A. et al. “Global Cancer Incidence and Mortality Rates and Trends - An Update”. Cancer Epidemiology, Biomarkers and Prevention, vol. 25, n. 1, 2016.
VAN DER KRUK, S. R. et al. “Psychosocial Well-Being and Supportive Care Needs of Cancer Patients and Survivors Living in Rural or Regional Areas: A Systematic Review from 2010 to 2021”. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, vol. 30, n. 2, 2022.
VARIAN - Varian Medical Systems. “ARIA Oncology Information System”. Varian [2023]. Disponível em: . Acesso em: 20/12/2023.
VIEIRA, C. M. et al. “Patient navigation (PN) support to timely access to radiotherapy in the Brazilian public health system”. Supportive Care in Cancer, vol. 31, n. 3, 2023.
WHO - World Health Organization. International Statistical Classification of Diseases and Related Health Problems 10th Revision. Geneva: World Health Organization, 2019.
WHO - World Health Organization. WHO report on cancer: setting priorities, investing wisely and providing care for all. Geneva: World Health Organization, 2020.
WHO - World Health Organization. World health statistics 2023: monitoring health for the SDGs, Sustainable Development Goals. Geneva: World Health Organization, 2023.
ZIETMAN, A. “Bringing Radiation Therapy to Underserved Nations: An Increasingly Global Responsibility in an Ever-Shrinking World”. International Journal of Radiation Oncology, Biology, Physics, vol. 89, n. 3, 2014.