Rural Radiation Oncology Clinic Closures Threaten Cancer Patient Care Across the U.S.
核心洞察
A nationwide study tracking over 3,000 radiation oncology clinics from 2018 to 2025 reveals that freestanding practices were 56% more likely to close than hospital-affiliated sites, with rural communities disproportionately affected.
As of 2025, 68.5% of U.S. counties—home to approximately 50.8 million people—had no radiation oncology practice site, with these areas showing higher poverty and uninsured rates.
The loss of a single rural clinic frequently leaves patients without local access to radiation therapy (搜索), forcing hours of daily travel for treatment that requires five visits per week over several weeks.
A new study led by researchers at the Icahn School of Medicine at Mount Sinai has revealed that the apparent stability in the total number of radiation oncology clinics across the United States masks a troubling pattern of closures disproportionately affecting rural and freestanding practices. Published in the International Journal of Radiation Oncology, Biology, Physics, the study is the first nationwide analysis to systematically track individual radiation oncology practice sites rather than physician groups or healthcare organizations.
Researchers examined more than 3,000 treatment locations nationwide using Centers for Medicare and Medicaid Services (搜索) data collected between 2018 and 2025. Their findings paint a stark picture of shifting access to a treatment modality used by more than half of all people diagnosed with cancer (搜索).
"Looking only at the total number of radiation oncology clinics gives the impression that access to care has remained stable," said senior author Kunal Sindhu, MD, Assistant Professor of Radiation Oncology at the Icahn School of Medicine. "But when we followed individual treatment sites over time, we found a much more dynamic picture. Clinics are disappearing, particularly in rural communities where patients often have few or no alternatives for receiving radiation therapy (搜索)."
Disproportionate Impact on Freestanding and Rural Practices
The study found that freestanding radiation oncology practices were 56 percent more likely to close than hospital-affiliated sites. Rural communities also faced a significantly greater risk of clinic closures compared with urban areas. Although the total number of radiation oncology clinics nationwide has remained relatively stable, the churn of openings and closures has masked important changes in patients' access to radiation therapy (搜索).
Unlike many other cancer (搜索) treatments, radiation therapy (搜索) typically requires patients to travel to a treatment center five days each week for several weeks. When a nearby clinic closes, patients may face hours of travel each day and may delay or even skip treatment altogether.
Geographic Disparities in Access
As of 2025, more than two-thirds of U.S. counties—68.5 percent, home to approximately 50.8 million people—had no radiation oncology practice site. These counties had higher poverty and uninsured rates, lower household incomes, and fewer primary care physicians than counties with local radiation therapy (搜索) services.
The consequences of clinic closures differed markedly depending on location. While patients in urban areas often still had access to nearby treatment centers, the loss of a single clinic in a rural community frequently left patients with little or no local access to radiation therapy (搜索), increasing the burden of traveling long distances for cancer (搜索) treatment.
"Our findings suggest that where a patient lives can increasingly determine how easy or difficult it is to receive radiation therapy (搜索)," Dr. Sindhu said. "Understanding which communities are most vulnerable can help policymakers and health systems develop strategies to preserve access before these gaps become even larger."
Policy Implications and Future Research
The investigators say the findings could help inform future policies designed to strengthen access to cancer (搜索) care in underserved communities and improve reimbursement models that support vulnerable radiation oncology centers. They also hope future research will examine how clinic closures affect patient outcomes and whether policy changes can improve long-term stability.
The study was conducted by researchers from the Icahn School of Medicine and Maimonides Medical Center. Co-authors include Catherine Yu, MD; Sifan "Grace" Lu, MD; and Danielle Arons, MD, who are residents in the Department of Radiation Oncology at Mount Sinai, as well as Jared P. Rowley, MD, Attending Physician, Radiation Oncology, Maimonides Health.