少数研究调查了地理可及性对癌症生存的影响，大多数研究侧重于参考护理中心的可及性，使用总体死亡率并仅限于特定的癌症部位。本研究旨在探讨法国 10 种最常见癌症患者获得初级保健与死亡率之间的关系，同时控制社会经济剥夺。这项研究总共纳入了法国 10 种最常见癌症部位的 151,984 例确诊病例。 21 2013 年至 2015 年间法国癌症登记处。使用两个指数估算获得初级保健的机会：Accessibilité Potentielle Localisée 指数（接触全科医生的机会）和 Scale 指数（接触一系列初级保健临床医生的机会）。使用基于基于生命表和观察到的死亡率的预期死亡率的附加框架对超额死亡率进行建模。生活在初级保健机会较少的地区的患者对于一些非常常见的癌症部位（如乳腺癌（女性）、肺癌（女性）、肺癌）的超额死亡率更高。男性）、肝癌（男性和女性）和结直肠癌（男性），占我们样本中诊断出的患者的 46%。对乳腺癌的效果最大；诊断后 1 年的超额风险比估计为 1.69 (95% CI, 1.20-2.38)，诊断后 5 年的超额风险比估计为 2.26 (95% CI, 1.07-4.80)。这项研究表明，这种初级保健获取机会的差异与癌症患者的死亡率过高，应成为卫生政策制定者减少医疗保健可及性方面的不平等的优先事项。© 2024 美国癌症协会。

The impact of geographical accessibility on cancer survival has been investigated in few studies, with most research focusing on access to reference care centers, using overall mortality and limited to specific cancer sites. This study aims to examine the association of access to primary care with mortality in excess of patients with the 10 most frequent cancers in France, while controlling for socioeconomic deprivation.This study included a total of 151,984 cases diagnosed with the 10 most common cancer sites in 21 French cancer registries between 2013 and 2015. Access to primary care was estimated using two indexes: the Accessibilité Potentielle Localisée index (access to general practitioners) and the Scale index (access to a range of primary care clinicians). Mortality in excess was modelized using an additive framework based on expected mortality based on lifetables and observed mortality.Patients living in areas with less access to primary care had a greater mortality in excess for some very common cancer sites like breast (women), lung (men), liver (men and women), and colorectal cancer (men), representing 46% of patients diagnosed in our sample. The maximum effect was found for breast cancer; the excess hazard ratio was estimated to be 1.69 (95% CI, 1.20-2.38) 1 year after diagnosis and 2.26 (95% CI, 1.07-4.80) 5 years after diagnosis.This study revealed that this differential access to primary care was associated with mortality in excess for patients with cancer and should become a priority for health policymakers to reduce these inequalities in health care accessibility.© 2024 American Cancer Society.