A new study led by researchers at the Icahn School of Medicine at Mount Sinai finds that while the total number of radiation oncology clinics in the United States appears to have stabilized in recent years, many individual treatment centers have quietly closed and others have opened. Closures have disproportionately affected rural and independent clinics, reducing access to life-saving radiotherapy for patients to receive life-saving cancer treatment closer to home.
Published in International Journal of Radiation Oncology, Biology and Physics (10.1016/j.ijrobp.2026.06.3090 ), This study is the first national analysis to systematically track individual radiation oncology practices rather than physician groups or institutions. Researchers surveyed more than 3,000 treatment facilities across the country using National Centers for Medicare and Medicaid Services data collected between 2018 and 2025.
If we look only at the total number of radiation oncology clinics, we get the impression that access to treatment is stable. However, tracking individual treated areas over time revealed a more dynamic picture. Clinics are disappearing, especially in rural areas where patients have little or no alternative means of receiving radiation therapy. ”
Kunal Sindhu, MD, senior author, assistant professor of radiation oncology at the Icahn School of Medicine
Radiation therapy is used to treat more than half of people diagnosed with cancer. Unlike many other cancer treatments, radiation therapy typically requires patients to attend a treatment center five days each week for several weeks. When nearby clinics close, patients face hours of travel each day, potentially delaying treatment or skipping treatment altogether.
Researchers found that independent radiation oncology clinics were 56 percent more likely to close than hospital-affiliated facilities, and that rural clinics were also at significantly higher risk of closure than urban clinics. Although the total number of radiation oncology clinics nationwide has remained relatively stable, the study found that many individual treatment centers have opened and closed over time, masking important changes in patient access to radiation therapy.
As of 2025, more than two-thirds (68.5 percent) of U.S. counties, home to approximately 50.8 million people, do not have a radiation oncology clinic. These counties had higher poverty and uninsured rates, lower household incomes, and fewer primary care physicians than counties with local radiotherapy services.
The impact of clinic closures varied by location. Although patients in urban areas often still had access to nearby treatment centers, the loss of one clinic in rural areas often meant that patients were unable to receive radiotherapy locally, increasing the burden of traveling long distances for cancer treatment.
“Our findings suggest that where a patient lives can increasingly determine whether it is easier or harder for them to receive radiotherapy,” Dr. Sindhu said. “Understanding which communities are most vulnerable can help policymakers and health systems develop strategies to maintain access before these disparities become even wider.”
Researchers say the findings could inform future policies aimed at strengthening access to cancer treatment in underserved areas and improving reimbursement models to support vulnerable radiation oncology centers. They also hope future studies will examine how clinic closures affect patient outcomes and whether policy changes can improve long-term stability.
The study was conducted by researchers at the Icahn School of Medicine and Maimonides Medical Center. Co-authors include Catherine Yu, MD; Sifan “Grace” Lu, MD; Daniel Aarons, M.D., resident in radiation oncology at Mount Sinai, and Jared P. Rowley, M.D., attending physician in radiation oncology at Maimonides Health.
sauce:
Mount Sinai School of Medicine
Reference magazines:
Yu, C. others. (2026) Structural weaknesses in the U.S. radiation oncology delivery system: Predictors and consequences of clinic disappearance. International Journal of Radiation Oncology*Biology*Physics. DOI: 10.1016/j.ijrobp.2026.06.3090. https://www.redjournal.org/article/S0360-3016(26)03986-6/fulltext
