Oncology Accessibility

Oncology Accessibility is a web application based on the methods published in our paper: "Disparities in accessibility to oncology care centers in France". The preprint is available on medrxiv.


Eric Daoud1,2, Anne-Sophie Hamy-Petit1,3, Elise Dumas1,4, Lidia Delrieu1, Beatriz Grandal Rejo1,5, Christine Le Bihan-Benjamin6, Sophie Houzard6, Philippe-Jean Bousquet7,10, Aude-Marie Savoye8, Christelle Jouannaud8, Judicaël Hotton9, Chloé-Agathe Azencott4, Marc Lelarge2, Fabien Reyal1,5,9


Background: Cancer caused nearly 10 million deaths in 2020. While most of the research focused on finding new treatments, accessibility to oncology care received less attention. However, studies showed that access to health services plays a key role in cancer survival. Spatial accessibility methods have been successfully applied to measure accessibility to primary care. Yet, little research focused on oncology care specifically.

Methods: We focused on care centers with medicine, surgery, or obstetric activity in metropolitan France. We proposed a clustering algorithm to automatically label the hospitals in terms of oncology specialization. Then, we computed an accessibility score to these care centers for every municipality in metropolitan France. Finally, we proposed an optimization algorithm to increase the oncology accessibility by identifying care centers to grow.

Results: We labelled 1,662 care centers into 8 clusters ordered by oncology specialization. About half of them were eligible for oncology care and 118 centers were identified as experts. We computed the oncology accessibility score for 34,877 municipalities in metropolitan France. Half of the population lived in the top 20% accessibility areas, and 6.3% in the bottom 20% zones. Accessibility was higher near dense cities, where the experts care centers were located. By combining the care centers clusters and the accessibility distributions, our optimization algorithm could identify hospitals to grow to reduce accessibility disparities.

Conclusions: Most of the lowest accessibility zones were sparsely populated rural areas, with no oncology specialized care centers nearby. While such areas were hard to improve, accessibility in suburban areas with intermediate level care centers could be addressed more easily. We packaged our method into a web application allowing the users to run the algorithms with various parameters and visualize the results. This accessibility score was deliberately non-specific to cancer type nor to the kind of stays, but it could easily be adapted to more specific scenarios.