RetroSearch Browse

Home - News ( United States | United Kingdom | Italy | Germany ) - Football scores

Showing content from https://pubmed.ncbi.nlm.nih.gov/32130791/ below:

Spatial access to primary care providers and colorectal cancer-specific survival in Cook County, Illinois

. 2020 May;9(9):3211-3223. doi: 10.1002/cam4.2957. Epub 2020 Mar 4. Spatial access to primary care providers and colorectal cancer-specific survival in Cook County, Illinois

Affiliations

¹ Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
² University of Illinois Cancer Center, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA.
³ Division of Gastroenterology & Hepatology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
⁴ Office of Community Health Systems, Washington State Department of Health, Olympia, WA, USA.
⁵ Institute of Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
⁶ Department of Sociology, College of Liberal and Sciences, University of Illinois at Chicago, Chicago, IL, USA.
⁷ Department of Geography and Geographic Information Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA.

PMID: 32130791
PMCID: PMC7196057
DOI: 10.1002/cam4.2957

Item in Clipboard

Spatial access to primary care providers and colorectal cancer-specific survival in Cook County, Illinois

Vincent L Freeman et al. Cancer Med. 2020 May.

. 2020 May;9(9):3211-3223. doi: 10.1002/cam4.2957. Epub 2020 Mar 4. Affiliations

¹ Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
² University of Illinois Cancer Center, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA.
³ Division of Gastroenterology & Hepatology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
⁴ Office of Community Health Systems, Washington State Department of Health, Olympia, WA, USA.
⁵ Institute of Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
⁶ Department of Sociology, College of Liberal and Sciences, University of Illinois at Chicago, Chicago, IL, USA.
⁷ Department of Geography and Geographic Information Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA.

PMID: 32130791
PMCID: PMC7196057
DOI: 10.1002/cam4.2957

Item in Clipboard

Abstract

Background: Spatial access to primary care has been associated with late-stage and fatal breast cancer, but less is known about its relation to outcomes of other screening-preventable cancers such as colorectal cancer. This population-based retrospective cohort study examined whether spatial access to primary care providers associates with colorectal cancer-specific survival.

Methods: Approximately 26 600 incident colorectal cancers diagnosed between 2000 and 2008 in adults residing in Cook County, Illinois were identified through the state cancer registry and georeferenced to the census tract of residence at diagnosis. An enhanced two-step floating catchment area method measured tract-level access to primary care physicians (PCPs) in the year of diagnosis using practice locations obtained from the American Medical Association. Vital status and underlying cause of death were determined using the National Death Index. Fine-Gray proportional subdistribution hazard models analyzed the association between tract-level PCP access scores and colorectal cancer-specific survival after accounting for tract-level socioeconomic status, case demographics, tumor characteristics, and other factors.

Results: Increased tract-level access to PCPs was associated with a lower risk of death from colorectal cancer (hazard ratio [HR], 95% confidence interval [CI]) = 0.87 [0.79, 0.96], P = .008, highest vs lowest quintile), especially among persons diagnosed with regional-stage tumors (HR, 95% CI = 0.80 [0.69, 0.93], P = .004, highest vs lowest quintile).

Conclusions: Spatial access to primary care providers is a predictor of colorectal cancer-specific survival in Cook County, Illinois. Future research is needed to determine which areas within the cancer care continuum are most affected by spatial accessibility to primary care such as referral for screening, accessibility of screening and diagnostic testing, referral for treatment, and access to appropriate survivorship-related care.

Keywords: colorectal cancer; primary care; prognosis; residence characteristics.

PubMed Disclaimer

Conflict of interest statement

None to disclose.

Figures
FIGURE 1

Selection of the final analytic…

FIGURE 1

Selection of the final analytic cohort. Cases diagnosed in the Veterans Health Administration…

FIGURE 1

Selection of the final analytic cohort. Cases diagnosed in the Veterans Health Administration healthcare system were not available for analysis. Total number of cases excluded was 845 (3.1%)

FIGURE 2

Mid‐period (2003‐2005) average number of…

FIGURE 2

Mid‐period (2003‐2005) average number of primary care providers (PCPs) per 10,000 residents (panel…

FIGURE 2

Mid‐period (2003‐2005) average number of primary care providers (PCPs) per 10,000 residents (panel A) and cumulative (2000‐2008) number of fatal colorectal cancer (CRC) cases per 10,000 residents (panel B) at the census tract level, Cook County, IL. Categories represent quintiles