We thank Leader and colleagues (1) for the first published article that explores the geographic coverage of U.S.-based cancer centers’ catchment areas. The use of county-level data and aggregated cancer statistics provides some insights regarding coverage of the U.S. population by cancer centers; however, more granular data are required for a fuller understanding of coverage gaps, as mentioned in the article. We share two relevant observations here.

First, the study found gaps in coverage in some states with rural populations but results also showed that most of the counties with balanced or overcoverage (population density overlay score > = 0) belong to the lower quintiles of population density, suggesting that the use of population density may downplay the challenges that come with reaching rural populations (2). Conversely, 48 of the 50 most densely populated counties exhibited undercoverage (population density overlay score < 0). As with the...

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