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Background: 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., Methods: 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., Findings: 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., Interpretation: 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.)

The recycling and utilization of phosphorus resources in sludge is becoming increasingly important. In this study, we compared the conversion of phosphorus and toxic metal passivation effects of different Ca additives under oxygen-rich combustion conditions and elucidated their specific mechanisms of action. The experimental results indicated that four Ca-based additives improved the recovery rate of total phosphorus, and promoted the generation of stable apatite phosphorus (AP). The effect of CaCl 2 and CaO was greater than that of Ca(OH) 2 and CaSO 4 . CaCl 2 promoted the formation of Ca 3 (PO 4 ) 2 and Ca 2 P 2 O 7 , and CaSO 4 improved the conversion of AlPO 4 to Ca(H 2 PO 4 ) 2 with increasing temperature. The conversion capacity of CaO on non-apatite inorganic phosphorus to AP was greater than that of Ca(OH) 2 , and more CaH 2 P 2 O 7 , Ca(PO 3 ) 2 , and Ca-Al-P minerals were found. Toxic metal percentages decreased after sludge incineration with CaCl 2 . Compared with CaO and Ca(OH) 2 , the toxic metal adsorption effect of CaSO 4 was more significant. The influence of Ca additives on the conversion of Zn into stable components was as follows: CaCl 2  > Ca(OH) 2  > CaO > CaSO 4 . Ca additives reduced the toxic metal contamination level and ecological risk index values, and the order of toxic metal contamination levels was Ni > Zn > Cr > Cu > Mn. The experiment confirmed the conversion of phosphorus and the toxic metal passivation effect of Ca additives during oxy-fuel combustion of sludge, which is beneficial for its resource utilization., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)