For a study, researchers sought to determine if there was a link between the density of obstetrician-gynecologists (ob-gyn) and primary care physicians (PCPs) at the county level and the incidence of gynecologic cancer in the United States.
In the Surveillance, Epidemiology, and End Results (SEER) database, a retrospective cohort analysis of gynecologic malignancies (uterine, ovarian, and cervical) was conducted from 2005 to 2018. The SEER database’s county-level demographics, the US Census Bureau’s population density, and the Area Health Resources File’s physician density (ob-gyns and PCPs/100,000 females) were all abstracted. Models of backward stepwise regression were applied.
The final study comprised 98,573 patients for the 5-year survival analysis and 113,938 patients for the stage at diagnosis analysis. Patients with uterine, ovarian, and cervical cancer made up 60.0%, 25.0%, and 15.0% of the total. The majority of counties (57%) had a mean PCP density of 89 per 100,000 females and an average ob-gyn density of 8 per 100,000 females. Increased PCP density was linked to earlier stage at diagnosis (95% CI -6.27 to -0.05; P =.05) and higher 5-year survival rates for cervical cancer (95% CI 0.03-0.09; P =.05), according to multivariate analysis. It was discovered that the density of obstetricians and gynecologists had no effect on the stage or prognosis of ovarian or uterine cancer. The percentage of people with bachelor’s degrees and metropolitan status were favorably connected with 5-year survival rates (P<.01), according to an analysis of sociodemographic characteristics for cervical cancer. Median household income was shown to be adversely correlated with the stage (P=.01). The percentage of Black females was negatively connected with 5-year survival rates for uterine cancer (P<.01) and positively correlated with stage (P<.01).
Increased PCP density, but not ob-gyn density, was linked to early stages of cervical cancer at diagnosis and better 5-year survival rates. All cancer types’ outcomes were also connected with county-level sociodemographic characteristics, such as population diversity, metropolitan status, educational attainment, and family income. Cervical cancer population-based care might be improved by focusing on PCP supply and education in lower-density regions.