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Radiation oncologist density and prostate cancer mortality.

72 Background: There exists a geographic variation among the distribution of radiation oncologists (RO). The goal of this study was to determine the effect of RO density (ROD) on prostate cancer (PC) mortality (PCM).


METHODS
Using county- level data from the 2008 Area Resource File, National Program for Cancer Registries, and US Centers for Disease Control, a multivariate regression model was constructed for PCM, controlling for county-level categorized ROD, demographics, socioeconomic status, and existing hospital facilities. Urologist and allergy/immunology density (UD and AID) were explored to assess whether the association with PCM was due to differences in regions with high medical specialist density or whether it was due to access to PC specific specialists.


RESULTS
There was a statistically significant reduction in PCM (reduction ranging from 9% to 29% p<.001) associated with counties that possessed at least 1 RO. Moreover, increasing the county density to greater than 2 ROs per 100,000 people had a statistical significant reduction in PCM compared to having one RO (p<.001). UD and AID were also associated with a reduction in PCM.


CONCLUSIONS
The presence of a RO is associated with lowered PCM within that county, and increasing ROD does yield further improvements in PCM. Whether access to specialized medical care is an indicator of available health resources or directly influences PCM improvement is an important area of further study. [Table: see text] No significant financial relationships to disclose.