The number of gynecologic oncologists in the United States has grown in recent years, but many patients still lack access to a gynecologic oncologist, according to research presented at the 2023 SGO Annual Meeting on Women’s Cancer.
“As of 2020, more than 95% of counties lacked a designated full-time gynecologic oncologist,” said study presenter Nerlyne Desravines, MD, of Johns Hopkins University School of Medicine in Baltimore, Maryland.
These counties encompassed 54 million potential patients, she added.
The patient population in this study consisted of women 18 years of age or older who were identified through data from a US Census Bureau survey. Accessibility to gynecologic oncologists was assessed by county, and having access was defined as living within 100 miles of a gynecologic oncologist.
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To obtain information on gynecologic oncologists, Dr Desravines and colleagues used 2 physician registries — the American Medical Association Masterfiles and the Society of Gynecologic Oncology membership list.
The data revealed a total of 495 gynecologic oncologists in 2001, and this number rose to 1178 by 2020. Just over half (51%) of these practitioners were early- to mid-career in 2020, and 98.3% were found in urban areas.
In 2020, 2 states — North Dakota and Wyoming — did not have a designated gynecologic oncology provider. Manhattan, New York, had the highest number of providers in the nation, at 53.
A total of 2862 counties (95%) did not have at least 1 provider in 2020, and these counties encompassed 54 million at-risk women. A total of 7.8 million women did not have a provider located within 100 miles of their county of residence.
Urban areas had 1.09 gynecologic oncologists per 100,000 women, and rural areas had 0.1 gynecologic oncologist per 100,000 women (P <.01). Accessibility to gynecologic oncologists in rural areas was similar in 2001-2005 (2.2%) and 2016-2020 (1.7%).
“At-risk women residing in rural counties exhibited inadequate access to gynecologic oncologists, which did not improve over time, despite a tremendous increase in providers during the study period,” Dr Desravines noted.
She and her colleagues also evaluated patients by race/ethnicity and found that access was lowest for American Indian/Alaskan Native patients and highest for Asian/Pacific Islander patients.
The patients were divided into quintiles according to accessibility scores. In the lowest quintile, the percentages of patients who did not have access to a gynecologic oncologist were as follows:
- American Indian/Alaskan Native patients — 25.57% in 2001-2005 and 23.67% in 2016-2020
- Hispanic patients — 10.04% in 2001-2005 and 9.46% in 2016-2020
- White patients — 7.55% in 2001-2005 and 6.42% in 2016-2020
- Black patients — 4.15% in 2001-2005 and 2.73% in 2016-2020
- Asian/Pacific Islander patients — 1.61% in 2001-2005 and 1.36% in 2016-2020.
Disclosures: Dr Desravines reported having no disclosures.
Reference
Desravines N, Desjardins M, Wethington S, Curriero F, Nickles Fader A. Geographic disparities in the U.S. gynecologic oncology workforce: Cancer care inequities and the paradox of more docs. SGO 2023. March 25-28, 2023.
