THE ESSENTIAL
- A French study highlights a link between limited access to primary care and excess cancer mortality, particularly for breast, colon, lung and liver cancers.
- Based on more than 150,000 cases from 2013 to 2015, it reveals that medically under-resourced areas, in other words medical deserts, promote late diagnoses and insufficient treatment coverage.
- As a result, for example, the most disadvantaged women have a 69% increased risk of death in the year following a diagnosis of breast cancer, and 126% over five years.
To what extent does access to primary care influence the survival of cancer patients? A recent study carried out by French researchers reveals a direct link between the lack of accessibility to general practitioners and excess mortality from breast, lung and even colon cancer. Their investigation, published in the journal Cancerhighlights the concrete consequences of medical deserts on public health.
Ten types of cancers under study
Unlike previous work, this national study, based on the French cancer registry covering 20% of the metropolitan population, includes the ten most common cancers in the country: breast, colorectal, lung, pancreas, prostate, melanoma, bladder, head. and neck, kidney, liver. By analyzing data from more than 150,000 patients diagnosed between 2013 and 2015, researchers used validated tools, such as SCALE (Special accessibility multiscalar index) and the APL (Localized Potential Accessibility), to assess accessibility to primary care, while taking into account the socio-economic disparities of patients.
The results confirm excess cancer mortality among patients with poor access to primary care. The figures speak for themselves: the most disadvantaged women have a 69% increased risk of death in the year following a diagnosis of breast cancer, and 126% over five years. For men, this risk reaches 9% at one year for lung cancer, and 52% at five years for liver cancer.
However, the impact varies depending on the cancer. For example, no link was found between accessibility to primary care and skin cancer mortality. An observation that scientists attribute to the difficulty of detecting these lesions in the context of consultation by a general practitioner.
The urgency of fighting against medical deserts
“The consequences of living in medically under-resourced areas are probably underestimated”note the researchers in a press release. These medical deserts encourage later diagnoses and less treatment for the side effects of treatments. Although geographic inequalities are less marked than social inequalities, they play a crucial role in the treatment of bronchial, colorectal and liver cancers.
To reduce this excess mortality, it appears more essential than ever to strengthen access to primary care in medical deserts, and thus to guarantee territorial equity in cancer care, according to scientists.
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