S1361
Interdisciplinary - Global health
ESTRO 2026
11 Department of Radiation Oncology, BC Cancer, Prince George, BC, Canada. 12 Department of Surgery, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada Purpose/Objective: Radiotherapy access in Brazil continues to exhibit marked inequities, particularly within resource- constrained regions. This investigation sought to characterize temporal trends and regional variations in travel distances for genitourinary cancer radiotherapy from 2019 to 2022, with analyses stratified by sex, racial and geographic factors. Material/Methods: Data were obtained from Brazil’s national Outpatient Procedure Authorization (APAC) database for the period 2019–2022, extracted in .dbc format and processed using Python. The dataset encompassed variables describing procedure type, year of treatment, patient demographics (sex and race), municipality of residence, treatment site (state and macroregion), and whether treatment occurred outside the home municipality. Travel distances between residence and treatment sites were calculated in kilometers using the Haversine formula, with the data incorporated into a Power BI database. Statistical analyses were conducted using IBM SPSS Statistics, version 29.0. A four-way analysis of variance (ANOVA) examined the main and interaction effects of year, region, sex, and race on travel distance, followed by an analysis of covariance (ANCOVA) adjusting for regional. Statistical significance was defined as p < 0.05. Results:
distances were 378.50 km (North), 247.59 km (Midwest), 148.87 km (Northeast), 70.36 km (Southeast), and 66.71 km (South) (overall p<0.001). State-level means ranged from 43.82 km (Rio de Janeiro, Southeast) to 1,222.31 km (Amapá, North) (p<0.001). By sociodemographics, non-White patients traveled farther than White patients (125.37 vs 87.53 km, p<0.001), and females farther than males (118.75 vs 106.23 km, p<0.001).
Conclusion: This study highlights significant geographic and racial inequities in access to genitourinary radiotherapy across Brazil, with disproportionate barriers affecting underserved regions, females, and non-White
populations. References: 1. Mendez LC, et al. Clin Oncol (R Coll
Radiol) 2018; 30: e29–36.2. Silverwood S, et al. Int J Radiat Oncol Biol Phys. 2024;118(4):891-899. doi: 10.1016/j.ijrobp.2023.10.030.3. Moraes FY, et al. 2015;92(4):707-12. doi: 10.1016/j.ijrobp.2014.12.063.4. Gouveia AG, et al. J Cancer Policy. 2024;39:100459. doi: 10.1016/j.jcpo.2023.100459.5. Viani GA, Gouveia AG, Bratti VF, et al. Lancet Oncol. 2022;23(4):531-539. doi: 10.1016/S1470-2045(22)00123-1.6. Hanna SA, et al. Lancet Reg Health Am. 2022;14:100333. doi: 10.1016/j.lana.2022.100333.7. Viani GA, et al. Int J Radiat Oncol Biol Phys. 2023;116(2):413-420. doi: 10.1016/j.ijrobp.2023.02.029. Keywords: Genitourinary cancer, access, disparities. Hypofractionation for the planet: environmental impact of pelvic radiotherapy in endometrial cancer Gopikrishna Shyam 1 , Marina Khan 2 , Tanja Dallemuenchmeyer 3 , Priyanka Patel 1 , Benjamin Taylor 1 , Ingrid White 1 1 Clinical Oncology, Guy's & St Thomas’ NHS Foundation Trust, London, United Kingdom. 2 Radiotherapy, Guy's & St Thomas’ NHS Foundation Trust, London, United Kingdom. 3 Net Zero Manager, Digital Poster 3170
Among 72,057 GU radiotherapy procedures, 46,145 (64.0%) involved care outside the home municipality. The national mean travel distance was 106.45 km and changed modestly over time (p<0.001). Temporal trends varied by macroregion: the North showed a 15.1% reduction in mean distance (p<0.001), the Midwest 5.3% (p<0.001), and the Northeast 1.9% (p<0.001); the Southeast showed no material change, while the South increased by 1.4% (p<0.001). Pronounced geographic disparities persisted: mean
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