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Does uneven geographic distribution of urologists effect bladder and prostate cancers mortality? National health insurance data in Korea from 2007-2011

Authors
Kim, Jae HeonSun, Hwa YeonKim, Hyun JungKo, Young MyoungChun, Dong-IlPark, Jae Young
Issue Date
12-9월-2017
Publisher
IMPACT JOURNALS LLC
Keywords
urologist density; bladder cancer; prostate cancer; mortality
Citation
ONCOTARGET, v.8, no.39, pp.65292 - 65301
Indexed
SCIE
SCOPUS
Journal Title
ONCOTARGET
Volume
8
Number
39
Start Page
65292
End Page
65301
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/82243
DOI
10.18632/oncotarget.18036
ISSN
1949-2553
Abstract
The relationship between distribution of urologists and mortality of bladder and prostate cancers has not been clearly established. The aim of this study was to investigate the relationship between uneven distribution of urologists and urologic cancer specific mortality at country level. Data from the National Health Insurance Service and National Statistical Office in Korea from 2007 to 2011 were analyzed in this ecological study. Univariate and multivariable regression analyses were performed to determine risk factors for age standardized mortality rates (ASMR) of bladder and prostate cancers. Linear regression analysis showed a markedly (p < 0.001) uneven distribution of urologists between metropolitan and non-metropolitan areas. There was no significant difference in cancer specific ASMRs for either bladder cancer or prostate cancer. Univariate analysis after adjusting for time showed that country area, urologist density, and income were significant factors affecting bladder cancer incidence (p < 0.001, p = 0.013, and p < 0.001, respectively). It also showed that the number of training hospitals was a significant factor for prostate cancer incidence (p = 0.002). Although country area showed borderline significance (p = 0.056) for ASMR of bladder cancer, urologist density was not related to ASMR of bladder cancer or prostate cancer. Although there was a marked difference in urologist density between metropolitan and non-metropolitan areas for these years analyzed, mortality rates of bladder and prostate cancers were not significantly affected by country area or urologist density.
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