P0446 - Geospatial Analysis of Preventative Resource Distribution and Colorectal Cancer Outcomes in Mississippi (MS): Emphasis on Disparities Between Rural and Urban Populations
University of Mississippi Medical Center Oxford, MS
Award: Presidential Poster Award
Tristan C. Orman, BS, Roy J. Duhe, PhD, Fazlay Faruque, PhD, Phi Le, PhD, Deirdre Rogers, PhD, Pegah Hosseini-Carroll, MD, Yousaf Zafar, MD University of Mississippi Medical Center, Jackson, MS
Introduction: Colorectal cancer (CRC) is a leading cause of death in MS, with the highest mortality rate in the US. Early screening reduces mortality. Faruque et al. (2015) highlighted disparities in CRC across MS, influencing the MS Colorectal Roundtable's (MSCCRT) 2015 plan for a 70% screening rate. Current analysis is crucial for effective resource allocation. This study will assess rural and racial disparities in CRC incidence, mortality, and screening resource distribution. Identifying structural factors contributing to CRC disparities in MS is essential for future prevention strategies.
Methods: The MS Department of Health provided data on licensed hospitals and ambulatory surgical facilities (ASF). A telephone survey confirmed colonoscopy availability and gathered 2021 volume data, including staff counts of gastroenterologists (GIs) and non-GI endoscopists. MS Cancer Registry provided CRC outcomes data. Correlation analyses assessed links between colonoscopy providers, facility accessibility, population density, and CRC outcomes by race and sex. Geographic distributions were mapped using ArcGIS, while R software analyzed CRC incidence and mortality across rural and urban regions by demographic factors.
Results: Telephone survey data had a 74.3% provider completion rate, with 74,960 colonoscopies performed in MS in 2021 based on capacity provided data. Table 1, Row B indicates a significant CRC incidence difference (p = 0.00000016) between high- and low-population-density counties (defined as above or below the MS average of 61.1 persons / square mile). Males and blacks show worse CRC outcomes compared to females. Table 1, Row C reveals a significant difference (p= 0.0009) in gastroenterologists (GIs) across population densities, but not for non-GI endoscopists. Image B shows ASFs with on-site colonoscopies, indicating a 70% chance in urban versus 10% in rural counties. ASFs are predominantly staffed by GIs. Hospital-based colonoscopy availability is higher in rural areas, often with a mix of GIs and non-GI endoscopists.
Discussion: Strong correlations exist between population densities and availability of colonoscopy services, underscoring disparities in access and health care infrastructure across MS. Disparities are magnified by sex, race, and geographic location. These are not unique to MS, but the subpopulations of MS have some of the worst outcomes compared to their cohorts nationwide. These correlations can help map the next plan and focus areas to reach a higher screening goal in MS.
Figure: Images A through E geocoded and mapped using ArcGIS. Image A. Hospital facilities offering on-site colonoscopies in 2021. Image B. Ambulatory surgical services offering on-site colonoscopies in 2021. Image C. Number of reported colonoscopies performed in 2021. Image D. Number of reported gastroenterologists in Mississippi by city and town in 2021. Image E. Number of non-gastroenterologist certified endoscopists in Mississippi by city and town in 2021
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Tristan Orman indicated no relevant financial relationships.
Roy Duhe indicated no relevant financial relationships.
Fazlay Faruque indicated no relevant financial relationships.
Phi Le indicated no relevant financial relationships.
Deirdre Rogers indicated no relevant financial relationships.
Pegah Hosseini-Carroll indicated no relevant financial relationships.
Yousaf Zafar indicated no relevant financial relationships.
Tristan C. Orman, BS, Roy J. Duhe, PhD, Fazlay Faruque, PhD, Phi Le, PhD, Deirdre Rogers, PhD, Pegah Hosseini-Carroll, MD, Yousaf Zafar, MD. P0446 - Geospatial Analysis of Preventative Resource Distribution and Colorectal Cancer Outcomes in Mississippi (MS): Emphasis on Disparities Between Rural and Urban Populations, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
