Relationship between physician supply and breast cancer survival: a geographic approach

Breast cancer is the most common cancer in women, accounting for nearly 30% of all female cancers. Breast cancer is the second leading cause of cancer mortality in women in the US. During the last two decades, the benefits of early detection, early intervention, and postoperative treatment have resulted in decreased breast cancer mortality in the US general population. However, the distribution of breast cancer mortality varies among geographic regions of the US. The reasons for this variation remain largely unknown. We choose to look for a possible association between the numbers of physicians in each city within the State of Florida and breast cancer survival among women aged 40+ residing in that particular city. Using Cox Proportionate Hazard Modeling, we found a direct association between the number of physicians practicing in a particular city and breast cancer survival in that particular city (P=0.0153), while controlling for other known risk factors affecting survival. To our knowledge, this is the first study to report an association between physician supply and cancer survival within defined geographic areas. This association shows as physician density consistently dropped in a defined geographic area so did time of survival among women with breast cancer.