Utilization of primary care may decrease colorectal cancer (CRC) incidence and death through greater receipt of CRC screening tests.
Dr Jeannie Ferrante and colleagues from Massachusetts, USA examined the association of primary care utilization with colorectal cancer incidence, deaths, and all-cause mortality.
The team evaluated persons aged 67 to 85 years diagnosed with colorectal cancer between 1994 and 2005 in U.S. Surveillance, Epidemiology, and End Results (SEER) regions matched with control patients.
|Persons with 5 to 10 visits had lower colorectal cancer mortality|
|Annals of Internal Medicine|
The team's main outcomes were primary care visits in the 4- to 27-month period before colorectal cancer diagnosis, colorectal cancer incidence, mortality, and all-cause mortality.
Compared with persons having 0 or 1 primary care visit, persons with 5 to 10 visits had lower colorectal cancer incidence, colorectal cancer mortality, and lower all-cause mortality.
The researchers noted that associations were stronger in patients with late-stage colorectal cancer diagnosis, distal lesions, and diagnosis in more recent years when there was greater Medicare screening coverage.
The team found that ever receipt of colorectal cancer screening and polypectomy mediated the association of primary care utilization with colorectal cancer incidence.
Dr Ferrante's team concludes, "Medicare beneficiaries with higher utilization of primary care have lower colorectal cancer incidence and mortality and lower overall mortality."
"Increasing and promoting access to primary care in the United States for Medicare beneficiaries may help decrease the national burden of colorectal cancer."