Geographic disparities in late stage breast cancer incidence: results from eight states in the United States

Abstract

BackgroundLate stage of cancer at diagnosis is an important predictor of cancer mortality. In many areas worldwide, cancer registry systems, available data and mapping technologies can provide information about late stage cancer by geographical regions, offering valuable opportunities to identify areas where further investigation and interventions are needed. The current study examined geographical variation in late stage breast cancer incidence across eight states in the United States with the objective to identify areas that might benefit from targeted interventions.MethodsData from the Surveillance Epidemiology and End Results Program on late stage breast cancer incidence was used as dependent variable in regression analysis and certain factors known to contribute to high rates of late stage cancer (socioeconomic characteristics, health insurance characteristics, and the availability and utilization of cancer screening) as covariates. Geographic information systems were used to map and highlight areas that have any combination of high late stage breast cancer incidence and significantly associated risk factors.ResultsThe differences in mean rates of late stage breast cancer between eight states considered in this analysis are statistically significant. Factors that have statistically negative association with late stage breast cancer incidence across the eight states include: density of mammography facilities, percent population with Bachelor’s degree and English literacy while percent black population has statistically significant positive association with late stage breast cancer incidence.ConclusionsThis study describes geographic disparities in late stage breast cancer incidence and identifies areas that might benefit from targeted interventions. The results suggest that in the eight US states examined, higher rates of late stage breast cancer are more common in areas with predominantly black population, where English literacy, percentage of population with college degree and screening availability are low. The approach described in this work may be utilized both within and outside US, wherever cancer registry systems and technologies offer the same opportunity to identify places where further investigation and interventions for reducing cancer burden are needed.

Racial disparities in all-cause mortality among younger commercially insured women with incident metastatic breast cancer

“…Unlike studies that used Medicare SEER data and detected survival disparities by income level among older women [52–54], we did not find that low SES predicted worse outcomes. Although the reasons for this different finding are unclear, it is possible that lower SES women who are younger and commercially insured have better access to screening and care than older, Medicare insured women with lower SES.…”

Does where you live influence how your vestibular schwannoma is managed? Examining geographical differences in vestibular schwannoma treatment across the United States

“…This is compared to Seattle, where 31 % of VS are less than 1 cm in size while only 15 % are greater than 3 cm in size. The association between geography and stage of disease at presentation and/or treatment selection has been seen with several other disease processes [31][32][33][34]. Explanations for such findings include local and regional inequalities in medical care access, differences in public assistance programs, racial and socioeconomic disparities, and variance…”

“…1). in population education levels [31][32][33][34][35][36][37]. Hypothesizing that rural areas carry a higher risk of late disease presentation, we sought to determine whether decreasing population density was associated with older age or larger tumor size at diagnosis.…”

Racial disparities in survival outcomes by breast tumor subtype among African American women in Memphis, Tennessee

“…More recently, it was reported that the incidence of breast cancer among AA women is almost equal to that of non‐Hispanic White women . The racial inequality in breast cancer survival has been attributed to several factors, such as socioeconomic status , geographical barriers to breast care , and treatment . Furthermore, AA women are more likely to be diagnosed with aggressive basal‐like breast tumors that are hormone receptor‐negative and that are associated with poorer breast cancer survival compared to other ethnic groups.…”