Rural-Urban Differences in Breast Cancer Stage at Diagnosis.

Content Provider	Europe PMC
Author	LeBlanc, Gabrielle Lee, Inkoo Carretta, Henry Luo, Yi Sinha, Debajyoti Rust, George
Copyright Year	2022
Abstract	Purpose: To analyze the extent to which rural-urban differences in breast cancer stage at diagnosis are explained by factors including age, race, tumor grade, receptor status, and insurance status.Methods: Using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) 18 database, analysis was performed using data from women aged 50–74 diagnosed with breast cancer between the years 2013 and 2016. Patient rurality of residence was coded according to SEER's Rural-Urban Continuum Code 2013: Large Urban (RUCC 1), Small Urban (RUCC 2,3), and Rural (RUCC 4,5,6,7,8,9). Stage at diagnosis was coded according to SEER's Combined Summary Stage 2000 (2004+) criteria: Localized (0,1), Regional (2,3,4,5), and Distant (7). Descriptive statistics were analyzed, and variations were tested for across rural-urban categories using Kruskall–Wallis and Kendall's tau-b tests. Additionally, odds ratios (ORs) and 95% confidence intervals for the three ordinal levels of rural-urban residence were calculated while adjusting for other independent variables using ordinal logistic regression.Results: The rural residence category showed the largest proportion of women diagnosed with distant stage breast cancer. Additionally, we determined that patients with residence in both large and small urban areas had statistically significantly lower odds of higher stage diagnosis compared to rural patients even after controlling for age, race, tumor grade, receptor status, and insurance status.Conclusions: Rural women with breast cancer show small but statistically significant disparities in stage-at-diagnosis. Further research is needed to understand local area variation in these disparities across a wide range of rural communities, and to identify the most effective interventions to eliminate these disparities.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8896172&blobtype=pdf
Page Count	8
Journal	Women's Health Reports [Womens Health Rep (New Rochelle)]
Volume Number	3
DOI	10.1089/whr.2021.0082
PubMed Central reference number	PMC8896172
Issue Number	1
PubMed reference number	35262058
e-ISSN	26884844
Language	English
Publisher	Mary Ann Liebert, Inc., publishers
Publisher Date	2022-02-14
Publisher Place	140 Huguenot Street, 3rd Floor New Rochelle, NY 10801 USA
Access Restriction	Open
Rights License	This Open Access article is distributed under the terms of the Creative Commons License [CC-BY] (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © Gabrielle LeBlanc et al., 2022; Published by Mary Ann Liebert, Inc.
Subject Keyword	breast cancer cancer stage rural-urban disparities medically underserved areas
Content Type	Text
Resource Type	Article
Subject	Maternity and Midwifery Advanced and Specialized Nursing Medicine Public Health, Environmental and Occupational Health Obstetrics and Gynecology