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Impact of County Rurality and Urologist Density on Urological Cancer Mortality in Illinois

2014; Lippincott Williams & Wilkins; Volume: 193; Issue: 5 Linguagem: Inglês

10.1016/j.juro.2014.11.100

1527-3792

Thomas Frye, Daniel J. Sadowski, Whitney E. Zahnd, Wiley D. Jenkins, Danuta Dynda, Georgia Mueller, Shaheen Alanee, Kevin T. McVary,

Global Cancer Incidence and Screening

No AccessJournal of UrologyAdult Urology1 May 2015Impact of County Rurality and Urologist Density on Urological Cancer Mortality in Illinois Thomas P. Frye, Daniel J. Sadowski, Whitney E. Zahnd, Wiley D. Jenkins, Danuta I. Dynda, Georgia S. Mueller, Shaheen R. Alanee, and Kevin T. McVary Thomas P. FryeThomas P. Frye , Daniel J. SadowskiDaniel J. Sadowski , Whitney E. ZahndWhitney E. Zahnd , Wiley D. JenkinsWiley D. Jenkins , Danuta I. DyndaDanuta I. Dynda , Georgia S. MuellerGeorgia S. Mueller , Shaheen R. AlaneeShaheen R. Alanee , and Kevin T. McVaryKevin T. McVary View All Author Informationhttps://doi.org/10.1016/j.juro.2014.11.100AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The urology work force is contracting at a time when service demand is increasing due to demographic changes, especially in rural areas. We investigated the impact of rural status and urologist density on kidney and renal pelvis, bladder and prostate cancer mortality at the county level in Illinois. Materials and Methods: We stratified the 102 Illinois counties by 2003 RUCCs as urban (36, RUCCs 1 to 3) and rural (66, RUCCs 4 to 9). Area Health Resource Files were used for county demographic data and urologist density. County level age adjusted mortality rates from 1990 to 2010 were derived from National Center for Health Statistics data using SEER*Stat. We examined the associations of urological cancer mortality rates with rural status and urologist density. Results: Average urologist density significantly differed between rural and urban counties (1.9 vs 3.4/100,000 population, p <0.01). The kidney and renal pelvis cancer mortality rate in rural counties was higher than in urban counties while that of prostate cancer was lower (4.9 vs 4.3 and 28.7 vs 32.2/100,000 population, respectively, each p <0.01). Urologist density correlated with the mortality rate of kidney and renal pelvis cancer (Pearson coefficient –0.33, p <0.01) but not with the bladder or prostate cancer mortality rate. Multiple regression analysis revealed that rurality and lower urologist density (p = 0.01 and <0.05) were significantly associated with higher kidney and renal pelvis cancer mortality. Conclusions: Rural residence and low urologist density were associated with increased kidney and renal pelvis cancer mortality on the county level in Illinois. Further expansion and testing of evidence-based telemedicine is warranted because remote technical consultation is now technologically feasible, effective, inexpensive and satisfactory to patients. References 1 : Future supply of urologists: projected to decrease dramatically between 2009-2025. J Urol2013; 189: e171. Link, Google Scholar 2 : HPRI data tracks: Urology workforce trends. Bull Am Coll Surg2012; 97: 46. 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Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byRaskolnikov D, Ngo S and Gore J (2019) High Burden of In-Person Kidney Cancer Surveillance in a Low Resource PopulationUrology Practice, VOL. 7, NO. 5, (373-377), Online publication date: 1-Sep-2020.Maganty A, Sabik L, Sun Z, Eom K, Li J, Davies B and Jacobs B (2019) Under Treatment of Prostate Cancer in Rural LocationsJournal of Urology, VOL. 203, NO. 1, (108-114), Online publication date: 1-Jan-2020.Nichols P, Kohn T, Haney N, Boorjian S, Gettman M, Patel H, Stimson C, Pierorazio P and Johnson M (2019) Access to Urological Care and Internet Connectivity in the United States: A Geospatial AnalysisUrology Practice, VOL. 6, NO. 5, (275-281), Online publication date: 1-Sep-2019.Uhlman M, Gruca T, Jarvie C, Ghareeb G, Morrison P, Han Y, Nepple K and Erickson B (2016) Taking the Procedure to the Patient: Increasing Access to Urological Procedural Care through OutreachUrology Practice, VOL. 4, NO. 4, (335-341), Online publication date: 1-Jul-2017.Halpern J, Mittal S, Shoag J, Hershman D, Wright J, Lee R and Hu J (2016) Temporal Trends and Practice Patterns in the Urology Work Force between Low and High Density Population AreasUrology Practice, VOL. 4, NO. 1, (91-95), Online publication date: 1-Jan-2017. Volume 193Issue 5May 2015Page: 1608-1614 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordsurinary bladder neoplasmsprostatic neoplasmsrural health serviceskidney neoplasmsmortalityAcknowledgmentsDrs. Steven Verhulst and Steven Scaife assisted with statistical analysis.MetricsAuthor Information Thomas P. Frye More articles by this author Daniel J. Sadowski More articles by this author Whitney E. Zahnd More articles by this author Wiley D. Jenkins More articles by this author Danuta I. Dynda More articles by this author Georgia S. Mueller More articles by this author Shaheen R. Alanee More articles by this author Kevin T. McVary Financial interest and/or other relationship with Allergan, Lilly/Icos, NxThera, Watson, Neotract, GlaxoSmithKline, and National Institute of Diabetes and Digestive and Kidney Diseases. More articles by this author Expand All Advertisement PDF downloadLoading ...