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Impact of primary care provider density on detection and diagnosis of cutaneous melanoma

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  • Nathaniel H Fleming
  • Madeline M Grade
  • Eran Bendavid

Abstract

Introduction: Early diagnosis of cutaneous melanoma is critical in preventing melanoma-associated deaths, but the role of primary care providers (PCPs) in diagnosing melanoma is underexplored. We aimed to explore the association of PCP density with melanoma incidence and mortality. Methods: All cases of cutaneous melanoma diagnosed in the United States from 2008–2012 and reported in the Surveillance, Epidemiology, and End Results (SEER) database were analyzed in 2016. County-level primary care physician density was obtained from the Area Health Resources File (AHRF). We conducted multivariate linear regression using 1) average annual melanoma incidence or 2) average annual melanoma mortality by county as primary outcomes, adjusting for demographic confounders and dermatologist density. Cox proportional hazard regression was conducted using individual outcome data from SEER with the same covariates. Results: Across 611 counties, 167,305 cases of melanoma were analyzed. Per 100,000 people, an additional 10 PCPs per county was associated with 1.62 additional cases of melanoma per year (95% CI 1.06–2.18, p

Suggested Citation

  • Nathaniel H Fleming & Madeline M Grade & Eran Bendavid, 2018. "Impact of primary care provider density on detection and diagnosis of cutaneous melanoma," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-11, July.
    • Handle: RePEc:plo:pone00:0200097
    DOI: 10.1371/journal.pone.0200097
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