Increasing primary care utilization prior to cancer diagnosis in association with cancer mortality.

• DOI: 10.1200/jco.2022.40.16_suppl.10548
• Publication Date: 2022-06-06T17:35:45Z
• Authors: Edmund Men Qiao; Kripa Guram; Nikhil V. Kotha; Rohith S. Voora; Alexander Qian; Grace S. Ahn; Sandhya Kalavacherla; Ramona Pindus; Tyler F. Stewart; Matthew P. Banegas; James Don Murphy; Brent S. Rose
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

10548 Background: Primary care physicians (PCPs) are significant contributors of early cancer detection yet few studies have investigated whether consistent primary translates to improved downstream outcomes. We evaluated the impact prior PCP utilization on metastatic disease at diagnosis and cancer-specific mortality (CSM) for a general cohort 12 tumor subtypes. Methods: identified patients ≥40 years, diagnosed from 2004-2017 within Veterans Health Administration. For our 5-year pre-diagnostic period, we binned visits into none (0 visits), some (1-4), annual (5). Multivariable logistic regression assessed effect Fine-Gray with non-cancer death as competing event their (CSM). These were repeated each subtype. Results: Among 245,425 patients, mean age was 66 years 5.7-year median follow-up. Compared 0 visits, associated 26% reduced odds (odds ratio (OR), 95% confidence interval (CI): 0.74 [0.71-0.76] P<0.01) 12% lower risk CSM (hazard (HR), CI: 0.88 [0.86-0.89] P<0.01). Annual 39% (OR, 0.61 [0.59-0.63] 21% (HR, 0.79 [0.77-0.81] subtypes, prostate had largest size (OR , 0.32 [0.30-0.35] (HR 0.51 [0.48-0.55] Pancreas lowest 0.87 [0.73-1.04] P: 0.12) 0.89 [0.82-0.97] The table displays additional Conclusions: Increased is decrease in CSM, greatest decrease. results when stratifying by Consistent must be emphasized cancer. [Table: see text]