Radiation clinic closures in rural areas threaten patient access to care

A growing number of radiation oncology clinics in rural areas are closing, creating significant challenges for patients seeking cancer treatment, according to a study led by researchers at the Icahn School of Medicine at Mount Sinai. The findings, published in the International Journal of Radiation Oncology, Biology, Physics, reveal a hidden crisis in access to radiation therapy, with freestanding and rural clinics disproportionately affected.

Study Reveals Rural Radiation Oncology Closures

The study, which analyzed data from 3,000 radiation oncology treatment sites across the U.S. Between 2018 and 2025, found that while the total number of clinics appeared stable, individual sites were disappearing at a significant rate. Freestanding practices were 56% more likely to close than hospital-affiliated ones, and rural clinics faced a higher risk of closure compared to urban counterparts. By 2025, 68.5% of U.S. Counties—home to 50.8 million people—had no radiation oncology practice site. These counties were characterized by higher poverty rates, lower incomes, and fewer primary care physicians than areas with local radiation therapy services.

“Looking only at the total number of clinics gives a misleading picture of stability,” said Kunal Sindhu, MD, senior author of the study. “When we tracked individual sites over time, we saw a dynamic picture where clinics are disappearing, particularly in rural communities where alternatives are scarce.”

Impact on Patient Access and Outcomes

Radiation therapy is critical for treating more than half of cancer patients, but its delivery requires frequent visits to a treatment center. The loss of a local clinic forces patients to travel long distances, increasing the risk of delayed or skipped treatments. In rural areas, the closure of a single clinic often leaves patients with no nearby options, exacerbating existing disparities.

“Where a patient lives can increasingly determine how easy or difficult it is to receive radiation therapy,” Sindhu said. “Understanding vulnerable communities can help policymakers develop strategies to preserve access before gaps widen.”

Broader Implications of Rural Hospital Closures

Rural hospitals play a foundational role in cancer care, providing screenings, diagnostics, and referrals even if they lack dedicated oncology services. A LinkedIn post highlighted that when these facilities close, patients face longer travel times, delayed diagnoses, and fragmented care. The post emphasized that rural hospitals support the cancer care pathway through services like imaging, pathology coordination, and emergency care, which are critical for early detection and treatment.

Call for Policy Reforms and Innovation

The study’s authors and healthcare experts advocate for policy reforms to address these challenges. Recommendations include improving reimbursement models, expanding telehealth, and investing in community-based oncology. A LinkedIn post noted the potential of artificial intelligence and remote monitoring to support rural cancer care, while emphasizing the need for payment systems that account for geographic and workforce disparities.

“Innovative payment models and technology adoption are critical to preserving access,” the post stated. “Without action, rural communities will continue to lose essential services, worsening cancer care disparities.”

The crisis underscores the urgent need for targeted interventions to protect rural cancer care infrastructure. As closures continue, the focus remains on preventing further gaps in access and ensuring that patients, regardless of location, can receive timely and effective treatment.