Breast Cancer Among Special Populations: Disparities in Care Across the Cancer Control Continuum

Paskett, Electra D.

doi:10.1007/978-3-319-16366-6_4

Cited by 9 publications

(9 citation statements)

References 53 publications

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“…25 Future research is needed to understand whether rural cancer survivors have environmental and personal needs related to treatment and survivorship care, such as lack of access to health services or financial strain, that must be addressed prior to interpersonal support needs. 8 Our findings add to the evidence that an ecologic approach is needed to understand and change physical activity behavior in rural cancer survivors. Strengths of this study include the use of multiple measures of social support.…”

Section: Discussionsupporting

confidence: 52%

“…3,4 Elevated psychosocial distress (eg, fear of recurrence, anxiety, depression) is not uncommon among cancer survivors and contributes to physical inactivity and poor quality of life among rural cancer survivors. 3,[5][6][7][8] Geographic isolation, inadequate transportation, and low access to health care and supportive oncology services and resources may contribute to rural-urban differences. 1,8,9 Social support is a coping resource and has been associated with reduced psychosocial distress and greater wellbeing among cancer survivors.…”

Section: Discussionmentioning

confidence: 99%

“…3,[5][6][7][8] Geographic isolation, inadequate transportation, and low access to health care and supportive oncology services and resources may contribute to rural-urban differences. 1,8,9 Social support is a coping resource and has been associated with reduced psychosocial distress and greater wellbeing among cancer survivors. [10][11][12] The stress-buffering effect hypothesis suggests that social support (eg, informational, emotional, tangible) may moderate the association between stress and poor health outcomes and behaviors, such as physical activity.…”

Section: Discussionmentioning

confidence: 99%

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Stress and Physical Activity in Rural Cancer Survivors: The Moderating Role of Social Support

Mama

Bhuiyan

Smyth

et al. 2020

The Journal of Rural Health

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Purpose Social support (SS) has been shown to moderate the relationship between psychological distress and physical activity (PA) in adults, including those with no history of cancer and cancer survivors (CS). The purpose of this study was to explore the relationship between stress and leisure‐time PA and test if SS is a moderator of this relationship in rural CS. Methods CS were recruited to Partnering to Prevent and Control Cancer (PPCC) and completed questionnaires assessing sociodemographics, leisure‐time PA, perceived stress, and SS. Hierarchical multivariable linear regression was used to assess the moderating role of SS on the association between stress and PA. Findings Cancer survivors (N = 219) were in their mid‐60s (M age = 64.3 ± 12.5 years) and overweight/obese (M BMI = 29.5 ± 6.8 kg/m2); over half were women (60.7%) and insufficiently active (59.4%); and 42.1% reported moderate‐to‐high perceived stress. Perceived stress was negatively correlated with PA (r = –.183, P = .044) and SS (r = –.470, P < .001), and SS was positively correlated with PA (r = .205, P = .025). However, SS did not moderate the association between stress and PA. Conclusions Rural CS reported higher stress and less PA than previously reported by urban CS, potentially contributing to rural cancer health disparities. Although previous studies have shown success in building SS to reduce stress and promote PA in CS, our results do not support the stress‐buffering hypothesis in rural cancer survivors. Further research is needed to understand factors related to PA in rural CS and determine strategies to reduce psychological distress and promote healthy behaviors in an effort to improve cancer survivorship.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Stress and Physical Activity in Rural Cancer Survivors: The Moderating Role of Social Support

Mama

Bhuiyan

Smyth

et al. 2020

The Journal of Rural Health

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“…week [8,12]. However, previous studies have found that rural cancer survivors are less likely to meet cancer-specific PA recommendations than urban cancer survivors [4,13,14]. Despite the overwhelming evidence supporting PA post-cancer diagnosis, more than half (50.7%) of rural cancer survivors report being physically inactive, or not doing any leisure-time PA lasting at least 10 minutes, compared to only 38.7% of urban cancer survivors [4].…”

Section: Introductionmentioning

confidence: 96%

Rural-urban differences in meeting physical activity recommendations and health status in cancer survivors in central Pennsylvania

Mama

Bhuiyan

Foo

et al. 2020

Support Care Cancer

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Background: This study explored rural-urban differences in meeting physical activity (PA) recommendations and health status in cancer survivors in central Pennsylvania and associations between PA and health status. Methods: Cancer survivors (N=2,463) were identified through a state cancer registry and mailed questionnaires assessing PA and health status. Rural-urban residence was based on county of residence at diagnosis. Participants self-reported frequency and duration of leisure-time PA and were classified as: 1) meeting aerobic recommendations (≥150 minutes/week), 2) muscle-strengthening recommendations (≥2 times/week), 3) both aerobic and muscle-strengthening recommendations, or 4) neither recommendation. Logistic regression models examined associations between rural-urban residence and meeting PA recommendations and associations between PA and health status, adjusting for cancer type, gender and income. Results: Nearly 600 (N=591, 24.0%) cancer survivors returned completed questionnaires (rural 9.5%, urban 90.5%). Half (50.0%) of rural cancer survivors reported no leisure-time PA compared to 35.2% of urban cancer survivors (p=.020), and urban cancer survivors were 2.6 times more likely to meet aerobic PA recommendations (95% CI: 1.1-6.4). Odds of reporting good physical and mental health were 2.3 times higher among survivors who reported meeting aerobic recommendations compared to those who did not meet PA recommendations (95% CI: 1.1-4.5), adjusting for rurality and covariates. Conclusions: Results demonstrate persistent rural-urban differences in meeting PA recommendations in cancer survivors and its association with self-reported health. These findings underscore the need for interventions to increase PA in rural cancer survivors in an effort to improve health status and reduce cancer health disparities in this population. dichotomized poor physical health days (≥7 days vs. <7 days), poor mental health days (≥7 days vs. <7 days), and poor physical or mental health days impeding activities (≥7 days vs. <7 days). Regression analyses included cancer type, gender, and income because they were associated with PA and rural-urban residence. Effect modification by rural-urban differences was assessed. Results Participant Characteristics Of the 2,463 cancer survivors mailed recruitment letters and questionnaires, 591 (24.0%) returned completed questionnaires and participated in this study (Figure 1); the response rate did not significantly differ between rural (19.8%) and urban (24.5%) cancer survivors (χ 2 =3.1, p=.078). Breast cancer survivors were most likely to return completed questionnaires, followed by gynecologic, prostate, and colorectal cancer survivors; lung cancer survivors were least likely to participate. Demographic characteristics, PA, and health status are summarized in Table 1 by rural-urban residence. Rural cancer survivors were significantly more likely to be unemployed (χ 2 =4.9, p=.025) than urban cancer survivors. Half (50.0%) of rural cancer survivors reported being physically inactive (re...

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“…There is also some evidence that rural residents are less likely to get screened for cancer (6): for example, an analysis of 2008 Behavioral Risk Factor Surveillance System (BRFSS) data showed that rural women were less likely to meet recommendations for mammography than urban women; that the proportion of women reporting appropriate cervical cancer screening decreased as rurality increased; and that individuals from rural areas were less likely to report colorectal cancer screening than individuals from urban areas (9). Furthermore, rural individuals may be less likely to receive follow-up testing after receiving abnormal screening results (10), and although findings are not consistent with regard to rural-urban differences in stage at diagnosis, some research suggests that women from rural areas are more likely to be diagnosed with more advanced breast cancer compared to their urban counterparts (11). …”

Section: Introductionmentioning

confidence: 99%

Making the Case for Investment in Rural Cancer Control: An Analysis of Rural Cancer Incidence, Mortality, and Funding Trends

Blake¹,

Moss²,

Gaysynsky³

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

297

261

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Estimates of those living in rural counties vary from 46.2–59 million, or 14–19% of the U.S. population. Rural communities face disadvantages compared to urban areas, including higher poverty, lower educational attainment, and lack of access to health services. We aimed to demonstrate rural-urban disparities in cancer and to examine NCI-funded cancer control grants focused on rural populations. Estimates of five-year cancer incidence and mortality from 2009–2013 were generated for counties at each level of the rural-urban continuum and for metropolitan versus non-metropolitan counties, for all cancers combined and several individual cancer types. We also examined the number and foci of rural cancer control grants funded by NCI from 2011–2016. Cancer incidence was 447 cases per 100,000 in metropolitan counties and 460 per 100,000 in non-metropolitan counties (p<0.001). Cancer mortality rates were 166 per 100,000 in metropolitan counties and 182 per 100,000 in non-metropolitan counties (p<0.001). Higher incidence and mortality in rural areas were observed for cervical, colorectal, kidney, lung, melanoma, and oropharyngeal cancers. There were 48 R- and 3 P-mechanism rural-focused grants funded from 2011–2016 (3% of 1655). Further investment is needed to disentangle the effects of individual-level SES and area-level factors to understand observed effects of rurality on cancer.

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Breast Cancer Among Special Populations: Disparities in Care Across the Cancer Control Continuum

Cited by 9 publications

References 53 publications

Stress and Physical Activity in Rural Cancer Survivors: The Moderating Role of Social Support

Stress and Physical Activity in Rural Cancer Survivors: The Moderating Role of Social Support

Rural-urban differences in meeting physical activity recommendations and health status in cancer survivors in central Pennsylvania

Making the Case for Investment in Rural Cancer Control: An Analysis of Rural Cancer Incidence, Mortality, and Funding Trends

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