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

International Journal of Health Geographics

Deborah M. Winn¹  Linda C. Harlan¹  Denise R. Lewis¹  Alicia Rolin¹  Li Zhu¹  Zaria Tatalovich² 

[1] Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda 20892, MD, USA;Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Dr. Suite 4E 446, Rockville 20850, MD, USA

关键词: Breast cancer;    Geographic disparities;    Late stage;    Cancer;   

Others  :  1231690
DOI  :  10.1186/s12942-015-0025-5

 received in 2015-06-03, accepted in 2015-10-12,  发布年份 2015

【 摘 要 】

Background

Late 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.

Methods

Data 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.

Results

The 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.

Conclusions

This 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.

【 授权许可】

   
2015 Tatalovich et al.

【 图 表 】

Fig.1.

Fig.2.

Fig.3.

Fig.4.

Fig.5.

Fig.1.

Fig.2.

Fig.3.

Fig.4.

Fig.5.

【 参考文献 】

• [1]Global Health Estimates. WHO 2013.. http://www.who.int/cancer/detection/breastcancer/en/index1.html webcite
• [2]Verma R, Bowen RL, Slater SE, Mihaimeed F, Johnes JL: Pathological and epidemiological factors associated with advanced stage at diagnosis of breast cancer. Br Med Bull 2012, 103:129-145.
• [3]Gerend M, Pai M: Social determinants of black-white disparities in breast cancer mortality: a review. Cancer Epidemiol Biomarkers Prev. 2008, 17:2913-2923.
• [4]Campbell RT, Li X, Dolecek TA, Barrett RE, Weaver KE, Warnecke RB: Economic, racial and ethnic disparities in breast cancer in the US: towards a more comprehensive model. Health Place 2009, 15:855-864.
• [5]Tian N, Wilson JG, Zhan FB: Spatial association of racial/ethnic disparities between late-stage diagnosis and mortality for female breast cancer: where to intervene? Int J Health Geogr 2011, 10:24. BioMed Central Full Text
• [6]MacKinnon JA, Duncan RC, Huang Y, Lee DJ, Fleming LE, Voti L, Rudolph M, Wilkinson JD: Detecting an association between socioeconomic status and late stage breast cancer using spatial analysis and area-based measures. Cancer Epidemiol Biomarkers Prev 2007, 16:756-762.
• [7]Roetzheim RG, Ferrante JM, Lee JH, Chen R, Love-Jackson KM, Gonzales EC, Fisher KJ, McCarthy EP: Influence of primary care on breast cancer outcomes among Medicare beneficiaries. Ann Fam Med. 2012, 10:401-411.
• [8]Kuzmiak CM, Haberle S, Padungchaichote W, Zeng D, Cole E, Pisano ED: Insurance status and the severity of breast cancer at the time of diagnosis. Academic radiology 2008, 15:1255-1258.
• [9]Onitilo AA, Liang H, Stankowski RV, Engel JM, Broton M, Doi SA, Miskowiak DA: Geographical and seasonal barriers to mammography services and breast cancer stage at diagnosis. Rural Remote Health 2014, 14:2738.
• [10]Dai D: Black residential segregation, disparities in spatial access to health care facilities, and late-stage breast cancer diagnosis in metropolitan Detroit. Health Place 2010, 16:1038-1052.
• [11]Coughlin SS, Richardson LC, Orelien J, Thompson T, Richards TB, Sabatino SA, Wu W, Cooney D: Contextual analysis of breast cancer stage at diagnosis among women in the United States, 2004. Open Health Serv Policy J 2009, 2:45-46.
• [12]Onitilo AA, Engel JM, Liang H, Stankowski RV, Miskowiak DA, Broton M, Doi SA: Mammography utilization: patient characteristics and breast cancer stage at diagnosis. Am J Roentgenol. 2013, 201:1057-1063.
• [13]Keller D, Guilfoyle C, Seriego J: Geographical influence on racial disparity in breast cancer presentation in the United States. Am Surg 2011, 77:933-936.
• [14]Clarke CA, Keegan THM, Yang J, Press DJ, Kurian AW, Patel AH, Lacey JV: Age-specific incidences of breast cancer subtypes: understanding the black-white crossover. JNCI 2012, 104:1094-1101.
• [15]Markossian TW, Hines RB: Disparities in late stage diagnosis treatment, and breast cancer-related death by race, age, and rural residence among women in Georgia. Women Health 2012, 53:317-335.
• [16]Kohler BA et al. Annual Report to the Nation on the Status of Cancer, 1975–2011, featuring incidence of breast cancer subtypes by race/ethnicity, poverty, and state. J Natl Cancer Inst. 2015.
• [17]Clegg LX, Reichman ME, Miller BA, Hankey BF, Singh GK, Lin YD, Goodman MT, Lynch CF, Schwartz SM, Chen VW, Bernstein L, Gomez SL, Graff JJ, Lin CC, Johnson NJ, Edwards BK: Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study. Cancer Causes Control 2009, 20:417-435.
• [18]Barry J, Breen N, Barrett M: Significance of increasing poverty levels for determining late-stage breast cancer diagnosis in 1990 and 2000. J Urban Health 2012, 89:614-627.
• [19]Henry K, Sherman R, Farber S, Cockburn M, Goldberg D, Stroup A: The joint effects of census tract poverty and geographic access on late-stage breast cancer diagnosis in 10 US States. Health Place 2013, 21C:110-121.
• [20]Davis CT, Williams VM, Marin E, Parker MR, Glass J: Health literacy and cancer communication. CA Cancer J Clin 2002, 52:134-149.
• [21]Freedman RA, Virgo KS, He Y, Pavluck AL, Winer EP, Ward EM, Keating NL: The association of race/ethnicity, insurance status, and socioeconomic factors with breast cancer care. Cancer 2010, 117:180-189.
• [22]Wang F, McLafferty S, Escamilla V, Luo L: Late-stage breast cancer diagnosis and health care access in Illinois. Prof Geogr 2008, 60:54-69.
• [23]Lian M, Struthers J, Schootman M: Comparing GIS-based measures in access to mammography and their validity in predicting neighborhood risk of late-stage breast cancer. PLoS One 2012, 7:e43000.
• [24]Mobley LR, Kuo TM, Watson L, Gordon Brown G: Geographic disparities in late-stage cancer diagnosis: Multilevel factors and spatial interactions. Health Place 2012, 18:978-990.
• [25]Jones AP, Haynes R, Sauerzapf V, Crawford SM, Zhao H, Forman D: Travel time to hospital and treatment for breast, colon, rectum, lung, ovary and prostate cancer. Eur J Cancer 2008, 44:992-999.
• [26]Elkin EB, Ishill NM, Snow JG, Panageas KS, Bach PB, Liberman L, Wang F, Schrag D: Geographic access and the use of screening mammography. Med Care 2010, 48:349-356.
• [27]Doescher MP, Jackson JE: Trends in cervical and breast cancer screening practices among women in rural and urban areas of the United States. J Public Health Manag Pract 2009, 15(3):200-209.
• [28]McLafferty S, Wang F, Luo L, Butler J: Rural–urban inequalities in late-stage breast cancer: spatial and social dimensions of risk and access. Environ Plan 2011, 38:726-740.
• [29]McLafferty S, Wang F: Rural–Urban disparities in late stage breast cancer risk in Illinois. Cancer 2009, 115:2755-2764.
• [30]Surveillance Epidemiolgy and End Results (SEER) Program, N.C.I. Health Service Areas (HSA). 2010. http://seer.cancer.gov/seerstat/variables/countyattribs/hsa.html. Accessed Jan 2015.
• [31]Greene FL, Page DL, Fleming ID et al. (eds). AJCC Cancer Staging Manual, 6th edition. 2002; p. 435.
• [32]Makuc DM, et al.: Health service areas for the United States. Vital Health Stat 1991, 2(112):1-102.
• [33]National Cancer Institute. Small area estimates for cancer risk factors and screening behaviors. 2014. http://sae.cancer.gov/. Accessed Jan 2015.
• [34]Health Resources and Services Administration. Area Resource File (ARF), National County-level Health Resource Information Database. 2011. http://www.arf.hrsa.gov/. Accessed Jan 2015.