Radiation oncologist density and colorectal cancer mortality.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 605-605 ◽  
Author(s):  
S. Aneja ◽  
J. B. Yu
Keyword(s):  
Colorectal Cancer ◽  
Radiation Therapy ◽  
Cancer Mortality ◽  
Cancer Registries ◽  
County Level ◽  
Radiation Oncologist ◽  
Healthcare Facilities ◽  
Radiation Oncologists ◽  
Level Data ◽  
The Impact

605 Background: Although the use of radiation therapy is increasing, there exists geographic variation among the distribution of radiation oncologists. The impact of this variation on colorectal cancer (CRC) outcomes remains unexplored. The goal of this study was to determine the effect of radiation oncologist density on CRC mortality. Methods: Using county-level data from the 2008 Area Resource File, National Program for Cancer Registries, and US Centers for Disease Control, a regression model was constructed for CRC mortality, controlling for county-level categorized radiation oncologists density, demographics, socioeconomic status and existing healthcare facilities. Results: There was a statistically significant reduction in CRC mortality (reduction in mortality ranging from 12% to 47%, p<0.001) associated with counties that possessed at least one radiation oncologist. However, increasing the county density to greater than two radiation oncologists per 100,000 people had no statistically significant reduction in CRC mortality. Conclusions: The presence of a radiation oncologist is associated with lowered mortality for CRC within that county, but increasing radiation oncologist density does not yield further improvements. Therefore, as the use of radiation therapy to treat CRC increases, a detailed understanding of distribution of the radiation oncologists is essential for providing the greatest improvement in cancer mortality outcomes. [Table: see text] No significant financial relationships to disclose.

Radiation oncologist density and esophageal cancer mortality.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 116-116
Author(s):  
S. Aneja ◽  
J. B. Yu
Keyword(s):  
Esophageal Cancer ◽  
Radiation Therapy ◽  
Cancer Mortality ◽  
Cancer Registries ◽  
County Level ◽  
Radiation Oncologist ◽  
Radiation Oncologists ◽  
Level Data ◽  
Resource File ◽  
The Impact

116 Background: Although the use of radiation therapy to treat esophageal cancer is increasing, there exists a geographic variation among the distribution of radiation oncologists. The impact of this variation on esophageal cancer (EC) outcomes remains unexplored. The goal of this study was to determine the effect of radiation oncologist density on EC mortality. Methods: Using county- level data from the 2008 Area Resource File, National Program for Cancer Registries, and U.S. Centers for Disease Control, a multivariate regression model was constructed for EC mortality, controlling for county-level categorized radiation oncologists density, demographics, socioeconomic status, and existing hospital facilities. Results: There was a statistically significant reduction in esophageal cancer mortality (reduction ranging from 22% to 79% p < 0.001) associated with counties that possessed at least one radiation oncologist. However, increasing the county density to greater than two radiation oncologists per 100,000 people had no statistically significant reduction in EC mortality. Conclusions: The presence of a radiation oncologist is associated with lowered mortality for EC within that county, but increasing radiation oncologist density does not yield further improvements. Therefore, as the use of radiation therapy to treat EC increases, a detailed understanding of distribution of the radiation oncologists is essential for providing the greatest improvement in EC mortality outcomes. [Table: see text] No significant financial relationships to disclose.

Radiation oncologist density and pancreatic cancer mortality.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 350-350 ◽  
Author(s):  
S. Aneja ◽  
J. B. Yu
Keyword(s):  
Pancreatic Cancer ◽  
Radiation Oncology ◽  
Cancer Mortality ◽  
Multidisciplinary Care ◽  
Cancer Registries ◽  
Health Care Facilities ◽  
Curative Treatment ◽  
County Level ◽  
Radiation Oncologist ◽  
The Impact

350 Background: Though the role of radiation oncologists (RO) in the curative treatment of pancreatic cancer (PC) is not well defined, RO are important for the multidisciplinary care of cancer patients. The impact of this variation on PC outcomes remains unexplored. The goal of this study was to determine the effect of RO density on PC mortality. Methods: Using county-level data from the 2008 Area Resource File, National Program for Cancer Registries, and U.S. Centers for Disease Control, a multivariate regression model was constructed for PC mortality, controlling for county-level categorized RO density, demographics, socioeconomic status, and existing health care facilities. Results: There was a statistically significant reduction in PC mortality (reduction ranging from 27% to 51% p<.001) associated with counties that possessed at least one RO. Also there existed a statistically significant improvement in mortality in counties with a density of at least two RO per 100,000 people compared to counties with one radiation oncologist per 100,000 people. Conclusions: The presence of a RO is associated with lowered morality for PC within that county. In contrast to our other density analyses investigating the association between radiation oncology density and colorectal cancer and esophageal cancer mortality, the association between additional RO and PC mortality was equivocal. This may reflect the varying use of radiation oncology in different counties for the curative treatment of PC. Our study suggests that RO play an important role in the treatment of PC. [Table: see text] No significant financial relationships to disclose.

How radiation oncologist accessibility influences treatment choice and quality in early-stage breast cancer: A SEER database analysis.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6031-6031
Author(s):  
Thomas M. Churilla ◽  
Patrick E. Donnelly ◽  
Christopher A. Peters
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Partial Mastectomy ◽  
Adjuvant Radiation ◽  
Seer Database ◽  
Radiation Oncologist ◽  
Radiation Oncologists ◽  
The Impact

6031 Background: Mastectomy and breast conserving therapy (BCT, partial mastectomy and adjuvant radiotherapy) are equivalent in survival for treatment of early stage breast cancer. This study evaluated the impact of radiation oncologist accessibility on choice of mastectomy versus BCT, and the receipt of radiotherapy after BCT. Methods: In the NCI SEER database, breast cancer cases from 2004-2008 were selected with the following criteria: T2N1M0 or less, lobular or ductal histology, and treatment with simple mastectomy or partial mastectomy (+/-) adjuvant radiation. The HRSA Area Resource File was combined to define average radiation oncologist density (ROD, number of radiation oncologists/100K people) by county over the same time period. Tumor characteristics, demographic information, and ROD were evaluated with respect to mastectomy rates and receipt of radiation therapy after BCT in univariate and multivariate analyses. Results: In the 118,961 cases analyzed, mastectomy was performed 33.3% of the time relative to BCT. After adjustment for demographic and tumor variables, the odds of having mastectomy versus BCT were inversely associated with ROD (OR [95% CI] = 0.94 [0.93-0.96]; p<0.001). Adjuvant radiation therapy was not administered in 23.4% of BCT cases. Likewise, the odds of having BCT without adjuvant radiation were inversely associated with ROD (0.96 [0.95-0.98]; p<0.001, table). Conclusions: There was a significant, inverse and linear relationship between ROD and mastectomy rates independent of demographic and tumor variables. An inverse trend was also observed for the omission of radiotherapy after BCT. Access to radiation oncologists was a factor in surgical choice and receiving appropriate BCT in early stage breast cancer. [Table: see text]

Association of area social determinants of health with prostate cancer mortality.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 49-49
Author(s):  
John Clark Henegan
Keyword(s):  
Prostate Cancer ◽  
Linear Regression ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Cancer Mortality ◽  
County Level ◽  
Clinical Factors ◽  
Independent Variables ◽  
Prostate Cancer Mortality ◽  
Level Data

49 Background: Validated clinical nomograms prognosticate survival for men with metastatic castrate resistant prostate cancer. In addition to clinical factors, significant disparities in survival in advanced prostate cancer are associated with social determinants of health (SDH). We performed a study of county-level data to evaluate SDH associated with prostate cancer mortality. Methods: County-level data regarding prostate cancer crude mortality rate (dependent variable) and crude incidence rate was extracted from the ten states with information at www.cancer-rates.info for the years 2006-2015. The 2014 Robert Wood Johnson County Health Rankings dataset was used for information regarding county demographics, clinical information, and available SDH(independent variables). A correlation analysis was performed between independent variables and only one variable was analyzed if a criterion of a correlation of ≥ 0.65 was present. All counties with ≤ 30 death in the specified time period or with incomplete independent variable information were excluded from analysis. A univariate linear regression analysis was performed. All individual independent variables with a statistically significant (p ≤ 0.05) association with the dependent variable were included in a multivariate linear regression model. Results: 275 counties were available for analysis. On multivariate analysis, independent variables statistically significantly associated with the crude rate of prostate cancer mortality included household income and the percentage of: a population ≥ 65 years of age, the population < 18 years of age, African Americans, the population classified as rural, women reporting a screening mammography, smokers, and uninsured patients. The multivariate model was associated with a R-squared of 0.62. Conclusions: In addition to differences in baseline clinical factors, prostate cancer quality metrics that evaluate survival should account SDH. Information from this study, if validated in subsequent work, could be used to develop a stepwise model to adjust for both clinical factors and SDH when measuring survival as a quality metric.

Radiation oncologist density and prostate cancer mortality.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 72-72
Author(s):  
S. Aneja ◽  
J. B. Yu
Keyword(s):  
Prostate Cancer ◽  
Multivariate Regression ◽  
Health Resources ◽  
Cancer Registries ◽  
County Level ◽  
Medical Specialist ◽  
Multivariate Regression Model ◽  
Prostate Cancer Mortality ◽  
Level Data ◽  
Resource File

72 Background: There exists a geographic variation among the distribution of radiation oncologists (RO). The goal of this study was to determine the effect of RO density (ROD) on prostate cancer (PC) mortality (PCM). Methods: Using county- level data from the 2008 Area Resource File, National Program for Cancer Registries, and US Centers for Disease Control, a multivariate regression model was constructed for PCM, controlling for county-level categorized ROD, demographics, socioeconomic status, and existing hospital facilities. Urologist and allergy/immunology density (UD and AID) were explored to assess whether the association with PCM was due to differences in regions with high medical specialist density or whether it was due to access to PC specific specialists. Results: There was a statistically significant reduction in PCM (reduction ranging from 9% to 29% p<.001) associated with counties that possessed at least 1 RO. Moreover, increasing the county density to greater than 2 ROs per 100,000 people had a statistical significant reduction in PCM compared to having one RO (p<.001). UD and AID were also associated with a reduction in PCM. Conclusions: The presence of a RO is associated with lowered PCM within that county, and increasing ROD does yield further improvements in PCM. Whether access to specialized medical care is an indicator of available health resources or directly influences PCM improvement is an important area of further study. [Table: see text] No significant financial relationships to disclose.

scholarly journals Research Note: U.S. Senate Elections and Newspaper Competition

1992 ◽  
Vol 13 ◽  
pp. 363-368
Author(s):  
Jan Vermeer
Keyword(s):  
Regional Difference ◽  
Economic Factors ◽  
County Level ◽  
Senate Elections ◽  
Daily Newspapers ◽  
Level Data ◽  
Election Results ◽  
The Impact ◽  
Newspaper Competition ◽  
Socio Economic Factors

The contextual factors that structure electoral contests affect election outcomes. This research examines the impact of one such factor, the existence of newspaper competition, on the closeness of election results for U.S. Senate elections, using county-level data. Using counties with cities over 50,000 in population, the study finds that additional daily newspapers in a county lead to closer elections. Controls for socio-economic factors are incorporated into the analysis. The possibility that the finding reflects a regional difference between the South and non-South is explored and rejected. Implications of these findings are briefly discussed.

scholarly journals The Impact of Antebellum Slavery on Contemporary Income Inequality

2017 ◽  
Vol 6 (1) ◽  
pp. 56-92
Author(s):  
Javier E. Del Cid ◽  
Dominick Tanoh ◽  
Ian N. Sexton ◽  
Haruna Takeda ◽  
Paul Martin Sommers
Keyword(s):  
South Carolina ◽  
Income Inequality ◽  
Positive Relationship ◽  
Total Population ◽  
Antebellum South ◽  
County Level ◽  
Southern States ◽  
Strong Positive Relationship ◽  
Level Data ◽  
The Impact

The authors relate county-level data on the population of slaves in the antebellum South to present-day county-level Gini ratios on income inequality.  Outside the five Deep Southern states of Louisiana, Mississippi, Alabama, Georgia, and South Carolina, the intensity of slavery in 1860 is associated with a lower degree of income inequality.  Inside these same five states in counties where the population of slaves accounted for more than 71 percent of the county’s total population in 1860, there is evidence of a strong positive relationship between slavery and contemporary income inequality.

Sign in / Sign up

Export Citation Format

Share Document