Influence of Primary Care Physician Availability and Socioeconomic Deprivation on Breast Cancer from 1988 to 2008: A Spatio-Temporal Analysis
作者： Lung-Chang Chien , Anjali D. Deshpande , Donna B. Jeffe , Mario Schootman
DOI: 10.1371/JOURNAL.PONE.0035737
关键词: Epidemiology 、 Affect (psychology) 、 Incidence (epidemiology) 、 Gerontology 、 Demography 、 Breast cancer 、 Socioeconomic status 、 Primary care physician 、 Medicine 、 Mortality rate 、 Cancer
摘要: Background Breast cancer is the most commonly diagnosed and second leading cause of death among women in United States. It unclear how county-level primary care physician (PCP) availability socioeconomic deprivation affect spatial temporal variation breast incidence mortality. Methods We used 1988–2008 public-use county-based data from nine Surveillance, Epidemiology, End Results (SEER) programs to analyze disparity PCP on early-stage incidence, advanced-stage mortality. The spatio-temporal analysis was implemented by a novel structural additive modeling approach. Results Greater significantly associated with higher mortality during entire study period while negatively up 1992. However, observed influence varied county. Conclusions showed important associations three indicators. effect these over time across counties. association stronger selected
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