In France, the lack of accessibility to general practitioners promotes excess mortality by cancer, according to a team of French researchers.
- A French study highlights a link between limited access to primary care and excess excess on cancer, especially for breast, colon, lung and liver cancers.
- Based on more than 150,000 cases from 2013 to 2015, it reveals that medically under-sized areas, in other words medical deserts, promote late diagnostics and insufficient treatment of treatments.
- As a result, for example, the most disadvantaged women have an increased risk of death of 69 % 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 by French researchers reveals a direct link between the lack of accessibility to general practitioners and excess mortality by breast, lung or even colon cancer. Their investigation, published in the journal Cancerhighlights the concrete consequences of medical deserts on public health.
Ten types of cancer under study
Unlike previous work, this national study, based on the register of French cancers covering 20 % of the metropolitan population, includes the ten most frequent cancers in the country: breast, colorectal, lung, pancreas, prostate, melanoma, bladder, head and neck, kidney, liver. By analyzing data of more than 150,000 patients diagnosed between 2013 and 2015, researchers used validated tools, such as the SCALE (Special Accessibility Multiscalar Index) and the APL (potential accessibility located), to assess accessibility to primary care, while taking into account the socio-economic disparities of patients.
The results confirm cancer excess mortality in patients with low accessibility to primary care. The figures speak for themselves: the most disadvantaged women have an increased risk of death of 69 % in the year following a diagnosis of breast cancer, and 126 % over five years. For men, this risk reaches 9 % to one year for lung cancer, and 52 % at five years for liver cancer.
However, the impact varies according to cancers. For example, no link was found between accessibility to primary care and mortality by skin cancer. An observation that scientists attribute to the difficulty of detecting these lesions in a framework of consultation by a general practitioner.
The urgency to fight against medical deserts
“The consequences of living in medically underlined areas are probably underestimated”note researchers in a press release. These medical deserts promote later diagnostics and a lesser management of the side effects of treatments. Although geographic inequalities are less marked than social inequalities, they play in particular a crucial role in the management of bronchial, colorectal and liver cancers.
To reduce this excess mortality, it appears more than ever to strengthen access to primary care in medical deserts, and thus guarantee territorial equity in the management of cancer, according to scientists.
Consult our digital video book,
Only an account creation is required to access it.
