title: Primary care physician supply and colorectal cancer.
abstract: OBJECTIVE
  Our goal was to determine if increasing primary care physician supply was associated with lower incidence and mortality rates for colorectal cancer.
  
  
  METHODS
  We performed an ecologic study of Florida's 67 counties, using data from the state tumor registry and the American Medical Association physician masterfile.
  
  
  METHODS
  Florida residents were included.
  
  
  METHODS
  We measured age-adjusted colorectal cancer incidence and mortality rates for Florida's 67 counties during the period 1993 to 1995.
  
  
  RESULTS
  Increasing primary care physician supply was negatively correlated with both colorectal cancer (CC) incidence (CC = -0.46; P < .0001) and mortality rates (CC = -0.29; P =.02). In linear regression that controlled for other county characteristics, each 1% increase in the proportion of county physicians who were in primary care specialties was associated with a corresponding reduction in colorectal cancer incidence of 0.25 cases per 100,000 (P < .0001) and a reduction in colorectal cancer mortality of 0.08 cases per 100,000 (P =.0008).
  
  
  CONCLUSIONS
  Incidence and mortality of colorectal cancer decreased in Florida counties that had an increased supply of primary care physicians. This suggests that a balanced work force may achieve better health outcomes.
authors.affiliation: Department of Family Medicine, University of Florida, 12901 Bruce B. Downs Blvd, MDC 13, Tampa, FL 33612, USA. rroetzhe@hsc.usf.edu
authors.forename: R G
authors.initials: RG
authors.lastname: Roetzheim
authors.forename: E C
authors.initials: EC
authors.lastname: Gonzalez
authors.forename: A
authors.initials: A
authors.lastname: Ramirez
authors.forename: R
authors.initials: R
authors.lastname: Campbell
authors.forename: D J
authors.initials: DJ
authors.lastname: van Durme
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D016001:Confidence Intervals; D005194:Family Practice / Q000379:methods; D005260:Female; D005431:Florida / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D010821:Physicians, Family / Q000600:supply & distribution*; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000639:trends; D011320:Primary Health Care / Q000379:methods; D011336:Probability; D012042:Registries; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D000078329:Workforce