A comparison of the stages at which cancer is diagnosed in physicians and in the general population in Taiwan

Yueh Han Hsu, Pei Tseng Kung, Yueh Hsin Wang, Yao Mao Chang, Wen Chen Tsai

Research output: Contribution to journalArticle

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Abstract

Background: Previous investigations have reported that physicians tend to neglect their own health care; however, they may also use their professional knowledge and networks to engage in healthier lifestyles or seek prompt health services. We sought to determine whether the stage at which cancer is diagnosed differs between physicians and nonphysicians. Methods: We conducted a nationwide matched cohort study over a period of 14 years in Taiwan. We accessed data from two national databases: the National Health Insurance Research Database and the Taiwan Cancer Registry File. We collected data on all patients with the 6 most common cancers in Taiwan (hepatoma, lung, colorectal, oral, female breast and cervical cancer) from 1999 to 2012. We excluded patients less than 25 years of age, as well as those with a history of organ transplantation, cancer or AIDS. We used propensity score matching for age, sex, residence and income to select members for the control (nonphysicians) and experimental (physicians) groups at a 5:1 ratio. We used χ2 tests to analyze the distribution of incident cancer stages among physicians and nonphysicians. We compared these associations using multinomial logistic regression. We performed sensitivity analyses for subgroups of doctors and cancers. Results: We identified 274 003 patients with cancer, 542 of whom were physicians. After propensity score matching, we assigned 536 physicians to the experimental group and 2680 nonphysicians to the control group. We found no significant differences in cancer stage distributions between physicians and controls. Multinomial logistic regression and sensitivity analyses showed similar cancer stages in most scenarios; however, physicians had 2.64-fold higher risk of having stage IV cancer at diagnosis in cases of female breast and cervical cancer. Interpretation: In this cohort of physicians in Taiwan, cancer was not diagnosed at earlier stages than in nonphysicians, with the exception of stage IV cancer of the cervix and female breast.

Original languageEnglish
Pages (from-to)E412-E418
JournalCMAJ
Volume187
Issue number13
DOIs
Publication statusPublished - Sep 22 2015

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Taiwan
Population
Neoplasms
Uterine Cervical Neoplasms
Propensity Score
Logistic Models
Databases
Breast Neoplasms
National Health Programs
Organ Transplantation
Health Services
Registries
Hepatocellular Carcinoma
Acquired Immunodeficiency Syndrome
Breast
Cohort Studies
Regression Analysis
Delivery of Health Care
Lung
Control Groups

ASJC Scopus subject areas

  • Medicine(all)

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A comparison of the stages at which cancer is diagnosed in physicians and in the general population in Taiwan. / Hsu, Yueh Han; Kung, Pei Tseng; Wang, Yueh Hsin; Chang, Yao Mao; Tsai, Wen Chen.

In: CMAJ, Vol. 187, No. 13, 22.09.2015, p. E412-E418.

Research output: Contribution to journalArticle

Hsu, Yueh Han ; Kung, Pei Tseng ; Wang, Yueh Hsin ; Chang, Yao Mao ; Tsai, Wen Chen. / A comparison of the stages at which cancer is diagnosed in physicians and in the general population in Taiwan. In: CMAJ. 2015 ; Vol. 187, No. 13. pp. E412-E418.
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