Limits...
The impact of preventive screening resource distribution on geographic and population-based disparities in colorectal cancer in Mississippi.

Faruque FS, Zhang X, Nichols EN, Bradley DL, Reeves-Darby R, Reeves-Darby V, Duhé RJ - BMC Res Notes (2015)

Bottom Line: Significant population-based and geographic disparities in CRC screening behaviors and CRC outcomes exist in Mississippi.The effects of CRC screening resources are related to CRC screening behaviors and outcomes at a regional level, whereas at the county level, socioeconomic factors are more strongly associated with CRC outcomes.Thus, effective control of CRC in rural states with high poverty levels requires both adequate preventive CRC screening capacity and a strategy to address fundamental causes of health care disparities.

View Article: PubMed Central - PubMed

Affiliation: GIS and Remote Sensing Program, University of Mississippi Medical Center, Jackson, MS, 39216-4505, USA. ffaruque@umc.edu.

ABSTRACT

Background: The state of Mississippi has the highest colorectal cancer (CRC) mortality rate in the USA. The geographic distribution of CRC screening resources and geographic- and population-based CRC characteristics in Mississippi are investigated to reveal the geographic disparity in CRC screening.

Methods: The primary practice sites of licensed gastroenterologists and the addresses of licensed medical facilities offering on-site colonoscopies were verified via telephone surveys, then these CRC screening resource data were geocoded and analyzed using Geographic Information Systems. Correlation analyses were performed to detect the strength of associations between CRC screening resources, CRC screening behavior and CRC outcome data.

Results: Age-adjusted colorectal cancer incidence rates, mortality rates, mortality-to-incidence ratios, and self-reported endoscopic screening rates from the years 2006 through 2010 were significantly different for Black and White Mississippians; Blacks fared worse than Whites in all categories throughout all nine Public Health Districts. CRC screening rates were negatively correlated with CRC incidence rates and CRC mortality rates. The availability of gastroenterologists varied tremendously throughout the state; regions with the poorest CRC outcomes tended to be underserved by gastroenterologists.

Conclusions: Significant population-based and geographic disparities in CRC screening behaviors and CRC outcomes exist in Mississippi. The effects of CRC screening resources are related to CRC screening behaviors and outcomes at a regional level, whereas at the county level, socioeconomic factors are more strongly associated with CRC outcomes. Thus, effective control of CRC in rural states with high poverty levels requires both adequate preventive CRC screening capacity and a strategy to address fundamental causes of health care disparities.

No MeSH data available.


Related in: MedlinePlus

Geographic availability of colorectal cancer screening resources within defined driving times. This map displays the area that can be reached within a 10 min (red), 20 min (green) or 30 min (purple) automobile drive from the primary practice site of Mississippi-licensed gastroenterologists currently practicing within the state
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4562344&req=5

Fig7: Geographic availability of colorectal cancer screening resources within defined driving times. This map displays the area that can be reached within a 10 min (red), 20 min (green) or 30 min (purple) automobile drive from the primary practice site of Mississippi-licensed gastroenterologists currently practicing within the state

Mentions: With the exception of the BRFSS-derived CRC screening data which are only available at the Public Health District level, data granularity can be increased by evaluating CRC characteristics at the county level. Using the ArcGIS 10.1 software package (Environmental Systems Research Institute, Inc., Redlands, California), drive time areas were calculated in which residents could travel to a colonoscopy facility within 10, 20 or 30 min for each facility (Fig. 6). Drive time areas were also calculated for residents to travel to a gastroenterologist’s primary practice site within 10, 20 or 30 min for each practice site (Fig. 7). Geographically, 52 % of Mississippi is beyond a 30-min drive to a facility which offers colonoscopy, whereas 79 % of the state territory is beyond a 30-min drive to a gastroenterologist’s primary practice site. However, 83 % of the state’s population, with a mean per capita income of $20,680, live within a 30-min drive to a colonoscopy facility. In contrast, the 17 % of Mississippians who reside beyond this area have a mean per capita income of $16,894. Also, 62 % of the state’s population, with a mean per capita income of $21,680, live within a 30-min drive to a gastroenterologist’s primary practice site, whereas the remaining 38 % of Mississippians who live beyond this area have a mean per capita income of $17,307. These income values are collective state-wide population-based averages.Fig. 6


The impact of preventive screening resource distribution on geographic and population-based disparities in colorectal cancer in Mississippi.

Faruque FS, Zhang X, Nichols EN, Bradley DL, Reeves-Darby R, Reeves-Darby V, Duhé RJ - BMC Res Notes (2015)

Geographic availability of colorectal cancer screening resources within defined driving times. This map displays the area that can be reached within a 10 min (red), 20 min (green) or 30 min (purple) automobile drive from the primary practice site of Mississippi-licensed gastroenterologists currently practicing within the state
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4562344&req=5

Fig7: Geographic availability of colorectal cancer screening resources within defined driving times. This map displays the area that can be reached within a 10 min (red), 20 min (green) or 30 min (purple) automobile drive from the primary practice site of Mississippi-licensed gastroenterologists currently practicing within the state
Mentions: With the exception of the BRFSS-derived CRC screening data which are only available at the Public Health District level, data granularity can be increased by evaluating CRC characteristics at the county level. Using the ArcGIS 10.1 software package (Environmental Systems Research Institute, Inc., Redlands, California), drive time areas were calculated in which residents could travel to a colonoscopy facility within 10, 20 or 30 min for each facility (Fig. 6). Drive time areas were also calculated for residents to travel to a gastroenterologist’s primary practice site within 10, 20 or 30 min for each practice site (Fig. 7). Geographically, 52 % of Mississippi is beyond a 30-min drive to a facility which offers colonoscopy, whereas 79 % of the state territory is beyond a 30-min drive to a gastroenterologist’s primary practice site. However, 83 % of the state’s population, with a mean per capita income of $20,680, live within a 30-min drive to a colonoscopy facility. In contrast, the 17 % of Mississippians who reside beyond this area have a mean per capita income of $16,894. Also, 62 % of the state’s population, with a mean per capita income of $21,680, live within a 30-min drive to a gastroenterologist’s primary practice site, whereas the remaining 38 % of Mississippians who live beyond this area have a mean per capita income of $17,307. These income values are collective state-wide population-based averages.Fig. 6

Bottom Line: Significant population-based and geographic disparities in CRC screening behaviors and CRC outcomes exist in Mississippi.The effects of CRC screening resources are related to CRC screening behaviors and outcomes at a regional level, whereas at the county level, socioeconomic factors are more strongly associated with CRC outcomes.Thus, effective control of CRC in rural states with high poverty levels requires both adequate preventive CRC screening capacity and a strategy to address fundamental causes of health care disparities.

View Article: PubMed Central - PubMed

Affiliation: GIS and Remote Sensing Program, University of Mississippi Medical Center, Jackson, MS, 39216-4505, USA. ffaruque@umc.edu.

ABSTRACT

Background: The state of Mississippi has the highest colorectal cancer (CRC) mortality rate in the USA. The geographic distribution of CRC screening resources and geographic- and population-based CRC characteristics in Mississippi are investigated to reveal the geographic disparity in CRC screening.

Methods: The primary practice sites of licensed gastroenterologists and the addresses of licensed medical facilities offering on-site colonoscopies were verified via telephone surveys, then these CRC screening resource data were geocoded and analyzed using Geographic Information Systems. Correlation analyses were performed to detect the strength of associations between CRC screening resources, CRC screening behavior and CRC outcome data.

Results: Age-adjusted colorectal cancer incidence rates, mortality rates, mortality-to-incidence ratios, and self-reported endoscopic screening rates from the years 2006 through 2010 were significantly different for Black and White Mississippians; Blacks fared worse than Whites in all categories throughout all nine Public Health Districts. CRC screening rates were negatively correlated with CRC incidence rates and CRC mortality rates. The availability of gastroenterologists varied tremendously throughout the state; regions with the poorest CRC outcomes tended to be underserved by gastroenterologists.

Conclusions: Significant population-based and geographic disparities in CRC screening behaviors and CRC outcomes exist in Mississippi. The effects of CRC screening resources are related to CRC screening behaviors and outcomes at a regional level, whereas at the county level, socioeconomic factors are more strongly associated with CRC outcomes. Thus, effective control of CRC in rural states with high poverty levels requires both adequate preventive CRC screening capacity and a strategy to address fundamental causes of health care disparities.

No MeSH data available.


Related in: MedlinePlus