To the editor:
The National Cancer Institute (NCI) would like to ensure readers of The Cancer Letter have the most accurate and up-to-date information about the publicly available NCI visualization tool focused on Catchment Areas of NCI-Designated Cancer Centers mentioned in the September 30, 2022, article (Vol 48, Issue 35, Conversation with The Cancer Letter) highlighting similar catchment area mapping efforts of the Association of American Cancer Institutes-Thomas Jefferson University Sidney Kimmel Cancer Center.
Specifically, the NCI web-based application—which visualizes the locations and geographic extent of 63 catchment areas of the 71 NCI-Designated Cancer Centers—was launched in early February 2022 and referenced in NCI’s corresponding article in Cancer Epidemiology, Biomarkers & Prevention, published in May 2022, titled “A National Map of NCI-Designated Cancer Center Catchment Areas on the 50th Anniversary of the Cancer Centers Program.”
The February 2022 launch of the webtool included 5-year (2015-2019 average) total population estimates by the entirety of a cancer center’s catchment area or by county within the catchment area. NCI recently updated the webtool in August 2022 with the addition of demographic variables (age, race, ethnicity, sex) (2015-2019) and 5-year cancer mortality rates (all sites, individual cancer sites) (2015-2019, rate per 100,000) for each of the catchment areas and their respective counties.
The NCI webtool also includes public access to the underlying statistics and catchment area/U.S. county shapefiles: https://gis.cancer.gov/ncicatchment/. And, as noted in NCI’s corresponding CEBP manuscript, the R code used to generate the geographic visualizations has been deposited in a publicly available repository on GitHub (https://github.com/idblr/NCI_Cancer_Center_Catchment_Areas).
The current iteration of the webtool is based on NCI-Designated Cancer Center designation status and reported catchment areas as of summer 2021. NCI’s Division of Cancer Control and Population Sciences and Office of Cancer Centers are working together to determine the best timing and process for updating cancer center designations and catchment areas as they evolve and would note such historical updates and changes on the website.
Thank you for this opportunity to provide clarification on the NCI webtool. We hope The Cancer Letter readers find the information helpful.
Robin C. Vanderpool, DrPH
on behalf of Drs. Peter DelNero, Ian D. Buller, Rena R. Jones, Zara Tatalovich, Henry P. Ciolino, and Robert T. Croyle
National Cancer Institute
To the editor:
In October 2021, upon endorsement by the NCI and its External Advisory Board, Huntsman Cancer Institute announced it had formalized a longstanding commitment to advance cancer research, prevention, and care in the Mountain West.
The area Huntsman Cancer Institute serves, or catchment area as defined by the National Cancer Institute, now includes the states of Utah, Idaho, Montana, Nevada, and Wyoming. More information about Huntsman Cancer Institute’s commitment to this region is available here.
Ashlee Harrison, MPA
Director, communications and public affairs,
Executive director, innovation and transformation,
Huntsman Cancer Institute
The Cancer Letter’s Matthew Ong responds:
We thank Dr. Robin Vanderpool and Ms. Ashlee Harrison for highlighting the manner in which catchment areas of cancer centers are reported and displayed.
Their comments warrant thorough consideration.
In May 2022, two separate studies designed to assess catchment area coverage in the U.S. were published concurrently in Cancer Epidemiology, Biomarkers & Prevention:
- The NCI study, which includes 63 NCI-designated cancer centers: A National Map of NCI-Designated Cancer Center Catchment Areas on the 50th Anniversary of the Cancer Centers Program; and
- A study by Thomas Jefferson University researchers and the Association of American Cancer Institutes, which surveyed 102 AACI member cancer centers, including 31 cancer centers that don’t have an NCI designation: Assessing the Coverage of US Cancer Center Primary Catchment Areas (The Cancer Letter, Sept. 30, 2022).
The NCI study focused on the catchment areas that are largely a subset of the catchment areas evaluated in the AACI-Jefferson study.
According to the NCI study, the number of people who live outside the catchment areas of NCI-designated cancer centers is estimated at about 40 million. According to the AACI-Jefferson study, the number of people who live outside catchment areas of the AACI member cancer centers is estimated at about 25 million.
According to the NCI study, the number of people who live outside the catchment areas of NCI-designated cancer centers is estimated at about 40 million. According to the AACI-Jefferson study, the number of people who live outside catchment areas of the AACI member cancer centers is estimated at about 25 million.
In the latest iteration of NCI’s interactive map, the percentage of the U.S. population covered by NCI-designated cancer centers is based on catchment area data from May 2021.
The NCI study and interactive map include expanded catchment area information from Huntsman Cancer Institute and Fred Hutchinson Cancer Center. The Huntsman expansion is also mentioned in the AACI-Jefferson paper, but is not reflected in the maps.
The two groups used different methods for collecting data. The NCI study used catchment area definitions collected from Cancer Center Support Grant submissions that were funded in fiscal years 2016–2021. Also, in summer 2021, NCI staff asked center directors to report any catchment area updates or changes that occurred after their most recent competitive resubmission.
The AACI-Jefferson study used an online survey to capture catchment area data over a brief period in 2021.
The AACI-Jefferson study concluded that “geographic gaps in cancer center catchment area coverage exist and may be propagating cancer disparities.”
“Efforts to ensure coverage to all Americans should be a priority of cancer center leadership,” the paper states.
The AACI-Jefferson study was “the first known geographic analysis and interpretation of the primary catchment areas of all U.S.-based cancer centers and identifies key geographic gaps important to target for disparities reduction,” the authors wrote. The study was spearheaded by Karen Knudsen, then-AACI president and enterprise director of Sidney Kimmel Cancer Center at Jefferson, who has since become the CEO of the American Cancer Society.
HCI’s Ashlee Harrison is, of course, correct in re-emphasizing that the catchment areas of some cancer centers have grown over the past year—most notably at HCI and Fred Hutch—as referenced in the Sept. 30 story (The Cancer Letter, April 1, 2022).
The NCI interactive map, also mentioned in the Sept. 30 story, includes catchment area definitions of 63 NCI-designated cancer centers. Today’s total of cancer centers, including basic laboratory cancer centers, stands at 71. Launched in February 2022, the NCI visualization tool is intended to provide an authoritative accounting of the state of catchment areas for NCI cancer centers.
NCI will update the map on an ongoing basis, as and when new data is available, to reflect shifting boundaries.
“NCI’s Division of Cancer Control and Population Sciences and Office of Cancer Centers are working together to determine the best timing and process for updating cancer center catchment areas as they evolve and would note such historical updates and changes on the website,” NCI’s Robin Vanderpool, chief of the Health Communication and Informatics Research Branch in DCCPS, said in a letter to The Cancer Letter.
An August 2022 update to the NCI interactive map also provides demographic information (age, race, ethnicity, sex; 2015-2019) as well as 5-year cancer mortality rates (all sites, individual cancer sites; 2015-2019, rate per 100,000) for each catchment area and its respective counties.
The NCI study, which focuses on NCI-designated cancer centers, found that:
- Over 77% of U.S. counties had at least one NCI-designated cancer center catchment area assignation; about 23% of counties were not covered;
- Nearly 88% of the U.S. population, or 285 million residents, were covered in the combined catchment areas; about 12% of the population, or 40 million Americans, were not covered; and
- 13% of U.S. counties appeared in two or more NCI-designated cancer center catchment areas.
The AACI-Jefferson study, which included data from non-NCI cancer centers, found that:
- About 85% of U.S. counties were covered in at least one cancer center’s primary catchment area;
- This means that about 15% of counties, which translates to about 25 million Americans, were not covered.
