{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T19:27:14Z","timestamp":1780514834784,"version":"3.54.1"},"reference-count":31,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The influence of provider density and access on well-differentiated thyroid cancer (DTC) survival is uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used the SEER18 database to study DTC patients undergoing surgery from 2000-2012. County-level endocrinologist and surgeon density were calculated. We evaluated the relationship between provider density and cause-specific survival controlling for demographic, socioeconomic, and treatment characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median endocrinologist density was 1.4\/100\u00a0000 residents, with 15.5% of patients living in a county with no endocrinologist. Survival increased by 11% for each endocrinologist\/100,000 people (P = .007). Median surgeon density was 14.8\/100\u00a0000 residents, with only 1.7% of patients living in a county with no general surgeon or otolaryngologist. No significant association between surgeon density and survival was identified (P = .06). Rural residence was independently associated with lower survival (P = .009).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>County-level endocrinologist density is associated with improved DTC survival. Results may reflect endocrinologist expertise, earlier diagnosis, or represent surrogacy for higher county-level access to specialized care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348221091958","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T13:34:34Z","timestamp":1653053674000},"page":"2626-2632","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of Endocrinologist and Surgeon Density on Well-Differentiated Thyroid Cancer Survival"],"prefix":"10.1177","volume":"88","author":[{"given":"Alexandria D.","family":"McDow","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Lanzotti","sequence":"additional","affiliation":[{"name":"Stritch, School of Medicine, Department of Urology, Loyola University Chicago, Maywood, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Whitney E.","family":"Zahnd","sequence":"additional","affiliation":[{"name":"South Carolina Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin C.","family":"MacKinney","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Wisconsin Swedish American Health System, Rockford, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Angelos","sequence":"additional","affiliation":[{"name":"Department of Surgery and MacLean Center for Clinical Medical Ethics, University of Chicago Pritzker School of Medicine, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Mellinger","sequence":"additional","affiliation":[{"name":"Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabha","family":"Ganai","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,5,19]]},"reference":[{"key":"bibr1-00031348221091958","volume-title":"Cancer Facts and Figures 2022","author":"American Cancer Society","year":"2022"},{"key":"bibr2-00031348221091958","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21654"},{"key":"bibr3-00031348221091958","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/965212"},{"key":"bibr4-00031348221091958","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-08-0960"},{"key":"bibr5-00031348221091958","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.1"},{"key":"bibr6-00031348221091958","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2013.0257"},{"key":"bibr7-00031348221091958","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12374"},{"key":"bibr8-00031348221091958","doi-asserted-by":"publisher","DOI":"10.1016\/j.currproblcancer.2012.03.007"},{"key":"bibr9-00031348221091958","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040297"},{"key":"bibr10-00031348221091958","unstructured":"U.S. Department of Health and Human Services Health Resources and Services Administration. Rockville, MD, USA. Area health resources file. https:\/\/datawarehouse.hrsa.gov\/topics\/ahrf.aspx. (Accessed April 30, 2016)."},{"key":"bibr11-00031348221091958","unstructured":"AACE Find an Endocrinologist. The American association of clinical endocrinologists (AACE). https:\/\/www.aace.com\/find-an-endo. https:\/\/www.aace.com\/find-an-endo Accessed April 30, 2016."},{"key":"bibr12-00031348221091958","unstructured":"Find an Endocrinologist. Hormone health network. Endocrine Society. Washington DC, USA. https:\/\/www.hormone.org\/find-an-endocrinologist\/find-an-endocrinologist-results?page=1&country=UNITEDSTATES. (Accessed April 30, 2016)."},{"key":"bibr13-00031348221091958","unstructured":"USDA Economic Research Service. Rural-Urban Continuum Codes Documentation; US Department of Agriculture. Washington DC, USA. 2013. https:\/\/www.ers.usda.gov\/data-products\/rural-urban-continuum-codes\/documentation.aspx. 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