Related Experiment Video
Updated: Jan 9, 2026
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Association Between Regional Competition and Cancer Screening Rates at Federally Qualified Health Centers
Seongwon Choi1, Aizhan Karabukayeva, Ganisher Davlyatov
1Author Affiliations: Department of Management, College of Business and Economics, California State University Los Angeles, Los Angeles, California (Dr Choi); Department of Health Administration & Policy, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (Drs Karabukayeva and Davlyatov); and School of Health and Applied Human Sciences, College of Health and Human Services, University of North Carolina Wilmington, Wilmington, North Carolina (Dr Opoku-Agyeman).
Federally Qualified Health Center (FQHC) competition negatively impacts cervical and colorectal cancer screening rates. Breast cancer screening was not significantly affected, suggesting nuanced effects on preventive care delivery.
Area of Science:
- Health Services Research
- Public Health
- Health Economics
Background:
- Federally Qualified Health Centers (FQHCs) are crucial for providing primary care to underserved populations.
- Understanding the impact of market competition on FQHCs' preventive service delivery is essential for optimizing cancer screening rates.
Purpose of the Study:
- To examine the association between FQHC competition and cancer screening rates for cervical, breast, and colorectal cancers.
- To analyze how the Herfindahl-Hirschman Index (HHI) of FQHC competition relates to screening performance.
Main Methods:
- Utilized secondary data from the Health Resources and Services Administration's Uniform Data System (2020-2022).
- Conducted multivariable regression analysis on FQHC screening rates, controlling for FQHC-level and zip code-level factors.
- Measured FQHC competition using the Herfindahl-Hirschman Index (HHI).
Main Results:
- A significant negative association was found between FQHC competition and cervical cancer screening rates (Coef. = -0.051, P < .01).
- FQHC competition also showed a significant negative association with colorectal cancer screening rates (Coef. = -0.045, P < .01).
- No significant relationship was observed between FQHC competition and breast cancer screening rates.
Conclusions:
- FQHC competition has a complex and nuanced impact on preventive care, specifically cancer screening.
- Strategies like enhanced outreach and care coordination are vital for FQHCs to improve screening rates among vulnerable populations.
- Further research is needed to understand competition's role and develop interventions to maintain or improve care quality in FQHCs.
