Access to radiotherapy in Hispanic and Latinx populations in the United States: An update.

Abstract

142 Background: Radiation therapy (RT) is a mainstay of oncology care and has been shown to optimize outcomes for patients in many settings. Disparities in access to RT therefore represent substandard care. The Hispanic/Latinx population has consistently faced disparities in oncology access and outcomes, with cancer being the leading cause of death in the Hispanic American population. In this study, we aim to evaluate recent research in RT disparities among the Hispanic/Latinx population in the United States since the seminal analysis from 2017 (PMID: 29904731). Methods: A PubMed literature search was conducted for articles published from January 2017 through March 2023. Four term combinations were utilized, including: (1) “Hispanic” and “Radiotherapy” and “Disparities”, (2) “Latino” and “Radiotherapy” and “Hispanic”, (3) “Hispanic” and “Radiation” and “Disparities”, and (4) “Latino” and “Radiation” and “Disparities.” All articles returned from each search were documented and duplicates were removed. Following the initial search, research studies qualifying for inclusion included studies taking place in the United States, examination of radiation oncology care, and examination of health disparities in the Hispanic/Latinx population. Articles meeting criteria were then organized by disparity type that they address. Results: Our initial PubMed search returned 245 articles. Of these articles, 60 met inclusion criteria and spanned 5 disparity-types: (1) Time to Treatment Initiation & Completion, (2) Receipt of Treatment and Guideline-Concordant Care, (3) Geography, (4) RT Clinical Trial Access and (5) Insurance and Treatment Center Type. The most common disparity evaluated (n=23 studies) was receipt of treatment and guideline-concordant care, showing that the Hispanic/Latinx population was found to be less likely to receive any treatment. Another commonly identified disparity (n=10 studies) was the time to treatment initiation and completion, which highlighted that compared to the Non-Hispanic White population, the Hispanic/Latinx population had greater times to initiating RT and decreased likelihood of timely completion. Additionally, the Hispanic/Latinx population faced disparities in RT access due to geography (n=4 studies), RT clinical trial access (n=3 studies), insurance and treatment center access (n=5 studies). Conclusions: Disparities in radiotherapy access and quality care remain prominent for the Hispanic/Latinx population, despite increasing interest in health care disparities research. This population faces disparities in access via a multitude of barriers. Continued health care disparities research with tangible intervention is needed in radiation oncology in order to properly understand and address this problem.