Correlation between County-Level Surgeon Density and Mortality from Colorectal Cancer

Area of Science:

• Public Health
• Surgical Oncology
• Health Services Research

Background:

• Colorectal cancer (CRC) remains a significant cause of mortality.
• Understanding the impact of surgical workforce density on CRC outcomes is crucial for public health.
• Geographic disparities in access to surgical care may influence cancer mortality rates.

Purpose of the Study:

• To investigate the association between the density of general surgeons (GS) and colorectal surgeons (CS) at the county level and CRC mortality.
• To identify other county-level characteristics that correlate with CRC outcomes.

Main Methods:

• Utilized data from the Area Resource File, US Census, and National Cancer Institute.
• Developed multivariate regression models to assess the impact of GS and CS density on CRC mortality (2005-2009).
• Controlled for CRC incidence, county demographics, and socioeconomic factors.

Main Results:

• Counties with at least one general surgeon (GS) showed a significant decrease in CRC-specific mortality.
• Increased GS density beyond 8 per 100,000 people did not yield further mortality reductions.
• Colorectal surgeon (CS) density was not associated with significant differences in CRC mortality.
• Metropolitan status, younger populations, and higher poverty rates were associated with CRC mortality.

Conclusions:

• General surgeon presence, not colorectal surgeon presence, is linked to reduced CRC mortality.
• Optimal GS density for reducing CRC mortality appears to be around 8 per 100,000 people.
• Equitable distribution of the surgical workforce across counties can improve population-level CRC outcomes.