Mortality from Renal and Pelvis Cancers Higher in Places with Fewer Docs

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WASHINGTON, D.C.—Mortality rates from kidney and renal pelvis cancers (KCa) are increased significantly in places with a low population density of physicians, a study showed.

This finding is possibly a result of decreased access to medical care and decreased testing to diagnose these cancers at an early stage, researchers stated.

The investigators, led by Benjamin R. Lee, MD, Professor of Urology and Oncology at Tulane University School of Medicine in New Orleans, analyzed age-adjusted annual mortality rates for PCa, bladder cancer (BCa), and KCa for Caucasian patients in U.S. counties from 2003 to 2007.

The researchers obtained these rates from the National Vital Statistics System of the Centers for Disease Control and Prevention. They obtained data on the number of physicians and the number of people in the United States from the U.S. Census Bureau. Dr. Lee and his colleagues formed high and low cancer mortality rate groups.

The high rate groups included 15 and 25 counties with the highest mortality rates for PCa, BCa, and KCa. The low rate group consisted of 15 and 25 counties selected from the same states as the high rate groups and which had the lowest rates.

For the 25-county groupings, the high- and low-rate counties had 8.5 and 3.4 KCa deaths per 100,000 population, respectively. The high-rate counties had a physician density of 14 per 10,000 population compared with 42.2 per 10,000 in the low rate counties, a significant difference between the groups, according to findings presented at the American Urological Association annual meeting. The study also showed that median annual family income was significantly lower in the high rate2011  than the low rate group ($42,515 vs. $53,350).

Similar findings emerged when the investigators restricted their analyses to the 15 highest- and lowest-rate counties. The KCa mortality rate was 9.0 per 100,000 population in the high-rate counties versus 3.4 per 100,000 in the low-rate counties. The physician density was 15.9 and 53.6 per 10,000, respectively.

BCa and PCa mortality was not associated with physician density. With regard to BCa, the high-rate counties had a significantly lower median family income than the low-rate counties ($42,664 vs. 49,733).

“Mortality from kidney cancer is multi-factorial,” Dr. Lee told Renal & Urology News. “While low physician density is one potential factor to identify the tumor, other factors such as tumor aggressiveness, histology, stage, and grade are also intrinsic factors to be taken into account.”
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