Access to care and stage at diagnosis for patients with lung cancer and esophageal cancer: analysis of the Savannah River Region Information System cancer registry data.
BACKGROUND
Disparities have been observed in both the incidences of lung and esophageal cancers and the survival of those patients. Our goals were to determine if race was associated with stage of cancer at diagnosis, and to identify predictors of advanced-stage lung and esophageal cancers.


METHODS
All cases of lung and esophageal cancer between 1991 and 1995 in the Savannah River Region Information System cancer registry were studied. Data were analyzed using logistic regression to identify independent predictors of advanced disease at the time of diagnosis.


RESULTS
Among lung cancer patients, histology and distance to nearest hospital predicted diagnosis at an advanced stage. Residence in an area with a high proportion of Medicaid recipients was a predictor of advanced stage in esophageal cancer patients.


CONCLUSIONS
In this predominantly rural area, decreased utilization of health services was evident among older, poor, black, rural cancer patients. Further investigation involving prospective data collection from cancer patients is warranted.
Silverstein
Marc D
MD
Center for Health Care Research, Medical University of South Carolina, Charleston 29425, USA.
Nietert
Paul J
PJ
Ye
Xiaobu
X
Lackland
Daniel T
DT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018672:Community Health Planning / Q000706:statistics & numerical data; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D012042:Registries / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013022:South Carolina / Q000453:epidemiology