GEOGRAPHIC MAPPING OF CANCER INCIDENCE IN DENMARK: IDENTIFYING POTENTIAL FOR DECENTRALIZED ONCOLOGY CARE IN LUNG CANCER CARE (HEATMAP-ONCO-LUNG)
Author(s)
Andreas Fanoe1, Marianne Botoft, PharmD2, Anders Davidsen, PharmD, PhD3;
1Roche Pharmaceuticals A/S, Medical Science Partner, Copenhagen V, Denmark, 2Roche Pharmaceuticals A/S, Copenhagen V, Denmark, 3Roche Pharmaceuticals A/S, Copenhagen, Denmark
1Roche Pharmaceuticals A/S, Medical Science Partner, Copenhagen V, Denmark, 2Roche Pharmaceuticals A/S, Copenhagen V, Denmark, 3Roche Pharmaceuticals A/S, Copenhagen, Denmark
OBJECTIVES: Geographic distance is a barrier in lung cancer care, were timely treatment impacts outcomes. We aimed to quantify geographic variations in lung cancer incidence across 98 Danish municipalities and assess the correlation between lung cancer incidence and travel distance to outpatient clinics. The goal was to identify regions where high cancer burden and significant travel barriers create a strong case for decentralized care.
METHODS: We conducted a geospatial analysis using national incidence data (Danish Health Data Authority, 2024) and population demographics from 2024. We estimated road distances from municipal centroids to the nearest clinics using a hybrid Haversine-based model (1.35 tortuosity factor). Linear regression was used to assess the distance-incidence relationship. Municipalities with <10,000 inhabitants were excluded. Four municipalities were excluded but retained 99.8% of Denmark's total population for analysis.
RESULTS: We found a moderate-to-strong, statistically significant correlation between distance to care and lung cancer incidence (R²=0.42, p<0.001), indicating systematic geographic disparities. We identified six municipalities (Sønderborg, Bornholm, Nordfyns, Kerteminde, Nyborg, and Vesthimmerlands) with the highest positive residuals, representing areas with a higher incidence than predicted by their distance to care. These priority municipalities have an average travel distance of 65 km and a combined population of 234,820, characterized by aging demographics.
CONCLUSIONS: The strong correlation confirms that geography is a crucial, persistent barrier in Danish lung cancer care. Our findings identify six specific municipalities that are prime candidates for decentralized treatment pilots. These regions combine a high clinical need, significant travel barriers, and favorable demographics, suggesting that targeted community-based services in these areas could substantially improve patient access and outcomes. The geospatial approach may serve as a tool for stakeholders to consider where logistical or convenience factors could influence decentralized lung cancer care planning.
METHODS: We conducted a geospatial analysis using national incidence data (Danish Health Data Authority, 2024) and population demographics from 2024. We estimated road distances from municipal centroids to the nearest clinics using a hybrid Haversine-based model (1.35 tortuosity factor). Linear regression was used to assess the distance-incidence relationship. Municipalities with <10,000 inhabitants were excluded. Four municipalities were excluded but retained 99.8% of Denmark's total population for analysis.
RESULTS: We found a moderate-to-strong, statistically significant correlation between distance to care and lung cancer incidence (R²=0.42, p<0.001), indicating systematic geographic disparities. We identified six municipalities (Sønderborg, Bornholm, Nordfyns, Kerteminde, Nyborg, and Vesthimmerlands) with the highest positive residuals, representing areas with a higher incidence than predicted by their distance to care. These priority municipalities have an average travel distance of 65 km and a combined population of 234,820, characterized by aging demographics.
CONCLUSIONS: The strong correlation confirms that geography is a crucial, persistent barrier in Danish lung cancer care. Our findings identify six specific municipalities that are prime candidates for decentralized treatment pilots. These regions combine a high clinical need, significant travel barriers, and favorable demographics, suggesting that targeted community-based services in these areas could substantially improve patient access and outcomes. The geospatial approach may serve as a tool for stakeholders to consider where logistical or convenience factors could influence decentralized lung cancer care planning.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH157
Topic
Epidemiology & Public Health
Disease
SDC: Oncology