Main Session
Sep
30
PQA 08 - Gastrointestinal Cancer, Nonmalignant Disease, Palliative Care
3403 - Impact of Prior Primary Care Utilization on Metastatic Disease and Mortality in Colorectal Cancer
Presenter(s)
Sakshith Reddy Chintala, MS - University of California San Diego Health, San Diego, CA
S. R. Chintala1, K. M. Morgan1, E. M. Qiao2, D. Sabater Minarim1, E. A. M. Duran3, J. Demb4, J. D. Murphy5, M. Banegas1, and B. S. Rose1; 1Department of Radiation Medicine and Applied Sciences, UC San Diego Health, San Diego, CA, 2Department of Radiation Medicine and Applied Sciences, UC San Diego Health, La Jolla, CA, 3Center for Health Equity Education and Research, University of California, San Diego, La Jolla, CA, 4Depatment of Radiation Medicine and Applied Science, UC San Diego Health, San Diego, CA, 5Department of Radiation Medicine and Applied Sciences, UC San Diego, La Jolla, CA
Purpose/Objective(s):
Primary care plays a crucial role in early cancer detection and timely intervention, which may improve colorectal cancer (CRC) outcomes. We evaluated the association between prediagnostic primary care provider (PCP) utilization and metastatic disease at diagnosis and cancer-related mortality among patients with CRC.Materials/Methods:
We conducted a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, including patients diagnosed with CRC from 2010 to 2017. PCP visits in the three years prior to diagnosis were categorized as absent (0 visits), some (1-2 visits), and annual (3 visits). Multivariable logistic regression assessed the impact of PCP utilization on metastatic disease at diagnosis, while competing risk Cox proportional hazards models evaluated CRC-specific mortality (CSM).Results:
Among 44766 patients with CRC, (8.2%) had no prior PCP visits, (47.2%) had some utilization, and (44.6%) had annual PCP visits. Compared to those with absent PCP utilization, patients with some PCP visits had 48% decreased odds of metastatic disease at diagnosis (Odds Ratio [OR]: 0.52; 95% Confidence Interval [CI]: 0.45-0.59; p<0.001) and 24% reduced risk of CSM (subdistribution hazard ratio [SHR]: 0.76; 95% CI: 0.71-0.82; p<0.001). Annual PCP utilization was associated with a 49% reduction in metastatic disease at diagnosis (OR: 0.51; 95% CI: 0.44-0.59; p<0.001) and a 26% decreased risk of CSM (SHR: 0.74; 95% CI: 0.68-0.79; p<0.001).Conclusion:
Greater primary care utilization before CRC diagnosis is associated with significantly lower odds of metastatic disease at diagnosis and reduced CRC-related mortality, with the strongest benefits observed in patients receiving annual PCP visits. Strengthening primary care engagement may improve early detection and survival outcomes in CRC patients.