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Availability of Primary Care Physicians and Racial Disparities in Colorectal Cancer-Related Mortality in the United States

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Abstract

Introduction

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States (US), however racial disparities in outcomes persist. We sought to assess the correlation of availability of primary care physicians (PCPs) and racial disparities in CRC-related mortality.

Methods

We studied the correlation between age-adjusted incidence and mortality rates of CRC among all 50 states and the District of Columbia (D.C.) from the Center for Disease Control (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) with the number of actively practicing PCPs in all 50 states and D.C. from the Association of American Medical Colleges (AAMC) State Physician Workforce Data Report. Pearson’s coefficient was used to study correlations and the two-sample t test was used for comparing state-level PCP/CRC ratios between the two groups. Statistical analysis was performed using VassarStats.

Results

The mean AAMR per 100,000 population for CRC was significantly higher among AA versus White populations (t = 5.79, p < 0.001). Higher state-wide PCP per CRC case ratio correlated with lower state-wide CRCrelated mortality (r = −0.36, p = 0.011). The mean PCP per CRC case ratio was significantly lower among AA compared to White populations (t = −15.95, p < 0.0001). Higher PCP per CRC case ratio correlated with lower CRC-related mortality among both White (r = −0.64, p < 0.0001) and AA (r = −0.57, p = 0.0002) populations.

Conclusions

These findings suggest that racial disparities in CRC-related mortality may at least in part be related to lower availability of PCPs. Efforts focused on the development of strategies focused on improving access to primary care may help bridge racial disparities in CRC-related outcomes.

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Availability of Data and Materials

Data used for this analysis are publicly available at https://wonder.cdc.gov/ (CDC Wonder database) and https://www.aamc.org/data-reports/workforce/report/state-physician-workforce-data-report (AAMC state physician workforce data report).

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Author information

Authors and Affiliations

  1. Division of Hematology, Oncology and Blood and Marrow Transplantation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Udhayvir Singh Grewal & Naomi Fei

  2. University of Iowa Holden Comprehensive Cancer Center, Iowa City, IA, USA

    Udhayvir Singh Grewal & Naomi Fei

  3. Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA

    Manik Aggarwal

  4. Division of Hematology and Oncology, Louisiana State University Health Sciences Center, Shreveport, LA, USA

    Shiva Jashwanth Gaddam

  5. Department of Internal Medicine, Cleveland Clinic Fairview Hospital, Cleveland, OH, USA

    Prabhat Kumar

  6. Department of Gastroenterology and Hepatology, Virginia Tech Carillion Clinic, Roanoke, VA, USA

    Subhash Chandra Garikipati

Authors
  1. Udhayvir Singh Grewal
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  2. Manik Aggarwal
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  3. Shiva Jashwanth Gaddam
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  4. Prabhat Kumar
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  5. Subhash Chandra Garikipati
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  6. Naomi Fei
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Contributions

USG, MA, and SJG contributed to collection of data, data analysis, and manuscript writing and review. PK and SCG contributed to data analysis and manuscript writing and review. NF contributed to conceptualization and manuscript writing and review.

Corresponding author

Correspondence to Naomi Fei.

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The authors declare no competing interests.

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The authors declare no competing interests.

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The present analysis was presented in abstract form at the Annual AACR meeting held in Orlando, FL in April, 2023.

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Grewal, U.S., Aggarwal, M., Gaddam, S.J. et al. Availability of Primary Care Physicians and Racial Disparities in Colorectal Cancer-Related Mortality in the United States. J Gastrointest Canc 55, 171–174 (2024). https://doi.org/10.1007/s12029-023-00956-x

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  • DOI: https://doi.org/10.1007/s12029-023-00956-x

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