Evidence map›Paper›PMID 26195578›Full record

ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2015

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

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Population-Based Study on Cancer Incidence in Pharmacist: A Cohort Study in Taiwan.International journal of environmental research and public health · 2021
    Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Yueh-Han HsuDepartment of Public Health and Department of Health Services Administration (Hsu), China Medical University, Taichung, Taiwan; Department of Internal Medicine (Hsu), Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan; Department of Healthcare Administration (Kung), Asia University, Taichung, Taiwan; School of Health Care Administration, Health Policy and Care Research Center (Chang), Taipei Medical University, Taipei, Taiwan; Department of Health Services Administration (Wang, Tsai), China Medical University, Taichung, Taiwan.
Pei-Tseng KungDepartment of Public Health and Department of Health Services Administration (Hsu), China Medical University, Taichung, Taiwan; Department of Internal Medicine (Hsu), Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan; Department of Healthcare Administration (Kung), Asia University, Taichung, Taiwan; School of Health Care Administration, Health Policy and Care Research Center (Chang), Taipei Medical University, Taipei, Taiwan; Department of Health Services Administration (Wang, Tsai), China Medical University, Taichung, Taiwan.
Yueh-Hsin WangDepartment of Public Health and Department of Health Services Administration (Hsu), China Medical University, Taichung, Taiwan; Department of Internal Medicine (Hsu), Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan; Department of Healthcare Administration (Kung), Asia University, Taichung, Taiwan; School of Health Care Administration, Health Policy and Care Research Center (Chang), Taipei Medical University, Taipei, Taiwan; Department of Health Services Administration (Wang, Tsai), China Medical University, Taichung, Taiwan.
Yao-Mao ChangDepartment of Public Health and Department of Health Services Administration (Hsu), China Medical University, Taichung, Taiwan; Department of Internal Medicine (Hsu), Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan; Department of Healthcare Administration (Kung), Asia University, Taichung, Taiwan; School of Health Care Administration, Health Policy and Care Research Center (Chang), Taipei Medical University, Taipei, Taiwan; Department of Health Services Administration (Wang, Tsai), China Medical University, Taichung, Taiwan.
Wen-Chen TsaiDepartment of Public Health and Department of Health Services Administration (Hsu), China Medical University, Taichung, Taiwan; Department of Internal Medicine (Hsu), Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan; Department of Healthcare Administration (Kung), Asia University, Taichung, Taiwan; School of Health Care Administration, Health Policy and Care Research Center (Chang), Taipei Medical University, Taipei, Taiwan; Department of Health Services Administration (Wang, Tsai), China Medical University, Taichung, Taiwan. wtsai@mail.cmu.edu.tw.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrevious 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.

methodsWe 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 χ(2) 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.

resultsWe 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.

interpretationIn 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.

Indexed as

PhysiciansAdultAgedAged, 80 and overCohort StudiesDatabases, FactualFemaleHumansLogistic ModelsMaleMatched-Pair AnalysisMiddle AgedNeoplasmsNeoplasm StagingPropensity ScoreTaiwan

Identifiers

PMID26195578
PMCPMC4577363

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.