Volume 48 | Number 4 | August 2013

Abstract List

Nengliang Yao, Stephen A. Matthews, Marianne M. Hillemeier Ph.D., M.P.H., Roger T. Anderson


To examine the relationship between radiation therapy resources and guideline‐concordant radiotherapy after breast‐conserving surgery () in entucky.

Data Sources

The registry and rea esource ile provided county‐level data describing cancer care resources and socioeconomic conditions of entucky residents.

Study Design

The outcome variable was rate of without radiotherapy in each county for 2000–2007. Eight‐year weighted average rates of radiation therapy providers and hospitals per 100,000 residents were explanatory variables of interest. Exploratory spatial data analyses and spatial econometric models were estimated.

Principal Findings

Appalachian counties in entucky had significantly fewer radiation oncologists, hospitals with radiation therapy facilities, and surgeons per 100,000 residents than non‐Appalachian counties. The likelihood of without radiation was significantly higher among Appalachian compared to non‐Appalachian women (42.5 percent vs. 29.0 percent,  < .001). Higher proportions of women not receiving recommended radiotherapy after were clustered in astern entucky around exington. This geographic disparity was partially explained by significantly fewer radiation therapy facilities in ppalachian entucky in adjusted analyses.


Scarce radiation therapy resources in ppalachian entucky are associated with disparities in receipt of guideline‐concordant radiotherapy, suggesting that policy action is needed to improve the cancer treatment infrastructure in disadvantaged mountainous areas.