Record Details

Title Geographic patterns of prostate cancer mortality and variations in access to medical care in the United States
Author Jemal, A
Secondary Authors Ward E, Wu X, Martin HJ, McLaughlin CC, Thun MJ
Publication Type (Help) article
Journal Cancer Epidemiol Biomarkers Prev
Month Mar
Year 2005
Pages 590-5
Volume 14
Number 3
Publisher
Address
Note doi: 10.1158/1055-9965.EPI-04-0522
URL http://cebp.aacrjournals.org/content/14/3/590.long
PubMed ID 15767335
NCI Id
EPub Date
Citation Jemal A, Ward E, Wu X, Martin HJ, McLaughlin CC, Thun MJ. Geographic patterns of prostate cancer mortality and variations in access to medical care in the United States. Cancer Epidemiol Biomarkers Prev. 2005 Mar;14(3):590-5. PMID 15767335. [http://cebp.aacrjournals.org/content/14/3/590.long.]
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Abstract

Striking geographic variation in prostate cancer death rates have been observed in the United States since at least the 1950s; reasons for these variations are unknown. The authors examined the association between geographic variations in prostate cancer mortality and regional variations in access to medical care, as reflected by the incidence of late-stage disease, prostate-specific antigen (PSA) utilization, and residence in rural counties. Mortality data from the National Center for Health Statistics, 1996 to 2000, and incidence data from 30 population-based central cancer registries from NAACCR, 1995 to 2000, were analyzed. Ecological data on the rate of PSA screening by registry area were obtained from the 2001 Behavioral Risk Factor Surveillance System. Counties were grouped into metro and nonmetro areas according to Beale codes from the Department of Agriculture. Pearson correlation analyses were used to examine associations. Significant correlations were observed between the incidence of late-stage prostate cancer and death rates for Whites (r = 0.38, P = 0.04) and Blacks (r = 0.53, P = 0.03). The variation in late-stage disease corresponded to about 14% of the variation in prostate cancer death rates in White men and 28% in Black men. PSA screening rate was positively associated with total prostate cancer incidence (r = 0.42, P = 0.02) but inversely associated with the incidence of late-stage disease (r = -0.58, P = 0.009) among White men. Nonmetro counties generally had higher death rates and incidence of late-stage disease and lower prevalence of PSA screening (53%) than metro areas (58%), despite lower overall incidence rates. These ecological data suggest that 10% to 30% of the geographic variation in mortality rates may relate to variations in access to medical care.



Keywords

Keyword
cancer
geographic
medical care
mortality
patterns
prostate