Primary care physician supply and colorectal cancer

OBJECTIVE Our goal was to determine if increasing primary care physician supply was associated with lower incidence and mortality rates for colorectal cancer. STUDY DESIGN We performed an ecologic study of Florida's 67 counties, using data from the state tumor registry and the American Medical Association physician masterfile. POPULATION Florida residents were included. OUTCOMES MEASURED We measured age-adjusted colorectal cancer incidence and mortality rates for Florida's 67 counties during the period 1993 to 1995. RESULTS Increasing primary care physician supply was negatively correlated with both colorectal cancer (CC) incidence (CC = -0.46; P < .001) and mortality rates (CC = -0.29; P =.02). In linear regression that controlled for other county characteristics, each 1% increase in the proportion of county physicians who were in primary care specialties was associated with a corresponding reduction in colorectal cancer incidence of 0.25 cases per 100,000 (P < .001) and a reduction in colorectal cancer mortality of 0.08 cases per 100,000 (P=.008). CONCLUSIONS Incidence and mortality of colorectal cancer decreased in Florida counties that had an increased supply of primary care physicians. This suggests that a balanceci ork force may achieve better health outcomes.