title: Spatial analyses identify the geographic source of patients at a National Cancer Institute Comprehensive Cancer Center.
abstract: OBJECTIVE
  We examined the geographic distribution of patients to better understand the service area of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, a designated National Cancer Institute (NCI) comprehensive cancer center located in an urban center. Like most NCI cancer centers, the Sidney Kimmel Comprehensive Cancer Center serves a population beyond city limits. Urban cancer centers are expected to serve their immediate neighborhoods and to address disparities in access to specialty care. Our purpose was to learn the extent and nature of the cancer center service area.
  
  
  METHODS
  Statistical clustering of patient residence in the continental United States was assessed for all patients and by gender, cancer site, and race using SaTScan.
  
  
  RESULTS
  Primary clusters detected for all cases and demographically and tumor-defined subpopulations were centered at Baltimore City and consisted of adjacent counties in Delaware, Pennsylvania, Virginia, West Virginia, New Jersey and New York, and the District of Columbia. Primary clusters varied in size by race, gender, and cancer site. Spatial analysis can provide insights into the populations served by urban cancer centers, assess centers' performance relative to their communities, and aid in developing a cancer center business plan that recognizes strengths, regional utility, and referral patterns.
  
  
  CONCLUSIONS
  Today, 62 NCI cancer centers serve a quarter of the U.S. population in their immediate communities. From the Baltimore experience, we might project that the population served by these centers is actually more extensive and varies by patient characteristics, cancer site, and probably cancer center services offered.
authors.affiliation: Department of Biostatistics and Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Shu-Chih
authors.initials: SC
authors.lastname: Su
authors.forename: Norma
authors.initials: N
authors.lastname: Kanarek
authors.forename: Michael G
authors.initials: MG
authors.lastname: Fox
authors.forename: Alla
authors.initials: A
authors.lastname: Guseynova
authors.forename: Shirley
authors.initials: S
authors.lastname: Crow
authors.forename: Steven
authors.initials: S
authors.lastname: Piantadosi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015142:Baltimore; D002173:Cancer Care Facilities; D002648:Child; D003691:Delaware; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008396:Maryland; D008875:Middle Aged; D054547:National Cancer Institute (U.S.) / Q000706:statistics & numerical data*; D009515:New Jersey; D009518:New York; D010414:Pennsylvania; D013223:Statistics as Topic / Q000379:methods*; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data; D014768:Virginia; D014903:West Virginia