Geographical Location and Stage of Breast Cancer Diagnosis: A Systematic Review of the Literature

Williams, Faustine; Jeanetta, Stephen C.; James, Aimee S.

doi:10.1353/hpu.2016.0102

Cited by 38 publications

(34 citation statements)

References 47 publications

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“…One limitation of our study is the homogeneity of socioeconomics factors in our cohort. As women belonged to a specific health insurance scheme, the range of socioeconomic factors such as deprivation index, working status and years of schooling was limited; this could explain why those were not differentially associated with advanced vs. early breast cancer, unlike in other studies, 22,36,37 possibly through lack of power. Likewise, smoking and alcohol consumption were less common than in the general population, making this cohort not truly representative of the general French population.…”

Section: Discussionmentioning

confidence: 91%

Modifiable risk factors for advanced vs. early breast cancer in the French E3N cohort

Veron

Gélot

Gusto

et al. 2019

Intl Journal of Cancer

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Advanced breast cancer (BC) is associated with heavier treatments and poorer prognosis than early BC. Despite mammographic screening, advanced BC incidence remains stable. Little is known about risk factors differentially associated with advanced BC. We analyzed factors predicting for postmenopausal advanced vs. early BC in the E3N cohort. E3N has been prospectively following 98,995 French women aged 50–65 years at baseline since 1990. Hazard ratios (HRs) and 95% confidence intervals (CIs) for advanced and early invasive BC were estimated with multivariate Cox competing risk hazard models. With a median follow‐up of 15.7 years, 4,941 postmenopausal BC were diagnosed, including 1,878 (38%) advanced BC. Compared to early BC, advanced BC was differentially associated with excess weight (HR 1.39 [95% CI = 1.26–1.53] vs. 1.08 [95% CI = 1.00–1.17], phomogeneity < 0.0001) and living in a rural area (HR 1.14 [95% CI = 1.00–1.31] vs. 0.93 [95% CI = 0.82–1.04], phomogeneity 0.02). Excess weight was the only differential risk factor for advanced BC for hormone‐dependent BC and for women compliant with screening recommendations. Previous mammography was associated with reduced advanced BC risk (HR 0.86 [95% CI = 0.73–1.00]) and increased early BC risk (HR 1.36 [95% CI = 1.18–1.56], phomogeneity < 0.0001), but only for hormone‐dependent BC. Excess weight appears to be mostly associated with advanced BC, especially hormone‐dependent BC. These results add to the evidence for maintaining weight within the recommended limits.

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Section: Discussionmentioning

confidence: 91%

Modifiable risk factors for advanced vs. early breast cancer in the French E3N cohort

Veron

Gélot

Gusto

et al. 2019

Intl Journal of Cancer

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“…Less access to cancer screening and oncology care in rural areas due to poorer spatial access to care, cost burdens, and greater uninsured rates among rural populations may contribute to this incidence/mortality dynamic (34,35). These access barriers may mean that rural residents are diagnosed at a more advanced stage of disease which can affect prognosis and treatment options (36, 37). Social and behavioral factors like higher poverty, greater social isolation, and higher levels of smoking, obesity and physical inactivity may also contribute to poorer cancer outcomes (38,39).…”

Section: Discussionmentioning

confidence: 99%

Rural–Urban Differences in Cancer Incidence and Trends in the United States

Zahnd

James

Jenkins

et al. 2018

Cancer Epidemiology, Biomarkers &Amp; Prevention

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312

267

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Cancer incidence and mortality rates in the United States are declining, but this decrease may not be observed in rural areas where residents are more likely to live in poverty, smoke, and forego cancer screening. However, there is limited research exploring national rural-urban differences in cancer incidence and trends. We analyzed data from the North American Association of Central Cancer Registries' public use dataset, which includes population-based cancer incidence data from 46 states. We calculated age-adjusted incidence rates, rate ratios, and annual percentage change (APC) for: all cancers combined, selected individual cancers, and cancers associated with tobacco use and human papillomavirus (HPV). Rural-urban comparisons were made by demographic, geographic, and socioeconomic characteristics for 2009 to 2013. Trends were analyzed for 1995 to 2013. Combined cancers incidence rates were generally higher in urban populations, except for the South, although the urban decline in incidence rate was greater than in rural populations (10.2% vs. 4.8%, respectively). Rural cancer disparities included higher rates of tobacco-associated, HPV-associated, lung and bronchus, cervical, and colorectal cancers across most population groups. Furthermore, HPV-associated cancer incidence rates increased in rural areas (APC = 0.724, < 0.05), while temporal trends remained stable in urban areas. Cancer rates associated with modifiable risks-tobacco, HPV, and some preventive screening modalities (e.g., colorectal and cervical cancers)-were higher in rural compared with urban populations. Population-based, clinical, and/or policy strategies and interventions that address these modifiable risk factors could help reduce cancer disparities experienced in rural populations.

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“…Prior cancer studies showed that rural cancer patients are more likely to have late stage diagnoses and poorer cancer outcomes. 2,[30][31][32][33][34][35] The association between rurality and stage IV cancer diagnosis persisted even when controlling for distance to Note. Bolding of the 95% confidence interval indicates the confidence interval does not cross 1 and is significant at P < .05.…”

Section: Discussionmentioning

confidence: 99%

Impact of Rurality on Stage IV Ovarian Cancer at Diagnosis: A Midwest Cancer Registry Cohort Study

Weeks

Lynch

West

et al. 2020

The Journal of Rural Health

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Purpose We aim to understand if rurality impacts patients’ odds of presenting with stage IV ovarian cancer at diagnosis independent of distance to primary care provider and the socioeconomic status of a patient's residential census tract. Methods A cohort of 1,000 women with ovarian cancer in Iowa, Kansas, and Missouri were sampled and analyzed from the cancer registries’ statewide population data. The sample contained those with a histologically confirmed primary ovarian cancer diagnosis in 2011‐2012. All variables were captured through an extension of standard registry protocol using standardized definitions and abstraction manuals. Chi‐square tests and a multivariable logistic regression model were used. Findings At diagnosis, 111 women in our sample had stage IV cancer and 889 had stage I‐III. Compared to patients with stage I‐III cancer, patients with stage IV disease had a higher average age, more comorbidities, and were more often living in rural areas. Multivariate analysis showed that rural women (vs metropolitan) had a greater odds of having stage IV ovarian cancer at diagnosis (odds ratio = 2.41 and 95% confidence interval = 1.33‐4.39). Conclusion Rural ovarian cancer patients have greater odds of having stage IV cancer at diagnosis in Midwestern states independent of the distance they lived from their primary care physician and the socioeconomic status of their residential census tract. Rural women's greater odds of stage IV cancer at diagnosis could affect treatment options and mortality. Further investigation is needed into reasons for these findings.

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Geographical Location and Stage of Breast Cancer Diagnosis: A Systematic Review of the Literature

Cited by 38 publications

References 47 publications

Modifiable risk factors for advanced vs. early breast cancer in the French E3N cohort

Modifiable risk factors for advanced vs. early breast cancer in the French E3N cohort

Rural–Urban Differences in Cancer Incidence and Trends in the United States

Impact of Rurality on Stage IV Ovarian Cancer at Diagnosis: A Midwest Cancer Registry Cohort Study

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