BACKGROUND A high cancer burden exists among indigenous populations worldwide. Canada and Greenland have similar geographic features that make health service delivery challenging. We sought to describe geographic access to radiotherapy for indigenous populations in both regions. METHODS We used geospatial analyses to calculate distance and travel-time from indigenous communities in Canada and Greenland to the nearest radiotherapy center. We calculated the proportion of indigenous communities and populations residing within a 1 and 2-hour drive of a radiotherapy center in Canada, and compared the proportion of indigenous versus non-indigenous populations residing within each drive-time area. We calculated the potential distance and travel-time saved if radiotherapy was available in northern Canada (Yellowknife and Iqaluit), and Greenland (Nuuk). RESULTS Median one-way travel from indigenous communities to nearest radiotherapy center in Canada was 268 km (3 h when considering any transportation mode), and 4111 km (6 h by plane) in Greenland. In Canada, 84% and 68% of indigenous communities were outside a 1 and 2-hour drive from a radiotherapy center, respectively. Only 2% of the total population in Canada resided outside a 2-hour drive from a radiotherapy center. However, indigenous peoples were 336 times more likely to live more than a 2-hour drive away, compared to non-indigenous peoples. Nearly 3 million km and 4000 h of travel could be saved over a 10-year period for patients with newly diagnosed cancers in Canada, and 7 million km and 10,000 h in Greenland, if radiotherapy was available in Yellowknife, Iqaluit and Nuuk. CONCLUSIONS Geography is an important barrier to accessing radiotherapy for indigenous populations in Canada and Greenland. A significant disparity exists between indigenous and non-indigenous peoples in Canada. Geospatial analyses can help highlight disparities in access to inform radiotherapy service planning.

中文翻译：

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检查加拿大和格陵兰岛土著居民接受放射治疗的地理可及性：衡量不平等以提供解决方案

背景世界范围内的土著人口中存在高癌症负担。加拿大和格陵兰具有相似的地理特征，这使得提供卫生服务具有挑战性。我们试图描述两个地区土著居民在地理上获得放射治疗的机会。方法 我们使用地理空间分析来计算从加拿大和格陵兰的土著社区到最近的放射治疗中心的距离和旅行时间。我们计算了居住在加拿大放射治疗中心 1 和 2 小时车程内的土著社区和人口的比例，并比较了居住在每个驾车时间区域内的土著人口与非土著人口的比例。我们计算了如果在加拿大北部（黄刀镇和伊魁特岛）和格陵兰岛（努克）进行放疗可节省的潜在距离和旅行时间。结果 从土著社区到加拿大最近的放射治疗中心的单程中位数为 268 公里（考虑任何交通方式时为 3 小时），格陵兰为 4111 公里（乘飞机 6 小时）。在加拿大，84% 和 68% 的土著社区分别位于距放射治疗中心 1 小时和 2 小时车程的范围内。加拿大只有 2% 的人口居住在距放射治疗中心 2 小时车程之外。然而，与非土著人民相比，土著人民居住在 2 小时车程以外的可能性高 336 倍。如果在耶洛奈夫、伊魁特和努克提供放射治疗，加拿大新诊断癌症患者可以在 10 年内节省近 300 万公里和 4000 小时的旅行时间，格陵兰岛可以节省 700 万公里和 10,000 小时的旅行时间。结论 地理是加拿大和格陵兰土著居民获得放射治疗的重要障碍。加拿大的土著和非土著人民之间存在显着差异。地理空间分析有助于突出在获取放射治疗服务规划方面的差异。