Exploring access to brachytherapy for cervical cancer in Texas: Geographic availability and distribution

BACKGROUND: Cervical cancer remains a leading diagnosis among women in the state of Texas and manifests in a backdrop of health access and care inequities. In our study we aim to examine and highlight the geographic gaps in availability of brachytherapy across the state. METHODS: Using data obtained from the Texas State Department of Health Services and industry records we identified a list of brachytherapy centers with active Ir-192 licenses. Using data obtained from the Texas Cancer Registry, we examined epidemiological rates of cervical cancer between 2010 and 2020, calculated the relative availability of centers across the state, and mapped our findings. RESULTS/DISCUSSION: There are currently 48 active HDR brachytherapy centers/providers for cervical cancer across 28 counties in Texas. The majority of counties across the state had no brachytherapy centers or providers. The highest number of brachytherapy centers were housed in Harris (n = 7) and Tarrant (n = 5) counties which are home to the Houston and Fort Worth metropolitan areas. Mismatches between high incidence and mortality rates and low brachytherapy availability were noted in public health regions and counties near the Texas-Mexico border regions and northern/northeastern regions of Texas. A mapping tool (tinyurl.com/BrachytherapyTX) was developed to visualize active brachytherapy centers offering definitive cervical cancer treatment. CONCLUSION: Our findings suggest that geographic discrepancies in brachytherapy availability for cervical cancer exist across the state of Texas. We hope to not only raise awareness for the inequity but also work towards implementing resources and sustainable solutions to help bridge the statewide gaps.