Rural–urban differences in the presentation, management and survival of breast cancer in Western Australia

The influence of socio-economic and surveillance characteristics on breast cancer survival: a French population-based study

“…As highlighted in our study, survival varied significantly by county (Sant et al, 2003b). This is probably due to differences in the distribution of stage at diagnosis (Sant et al, 2003b) or to differences in the nature of the county (more urban or more rural) (Mitchell et al, 2006). We suggest that surveillance practices (a gynaecology consultation or a mammography during the years before diagnosis) as well as the circumstances of the mammography (screening or not) resulting from differences in the screening programmes in the counties may have influenced the stage at diagnosis.…”

Rural disadvantage in breast cancer health-care service use and outcomes: quantifying the effects of individual risk factors and health service risk factors

“…For women diagnosed with breast cancer, studies in several developed countries around the world have shown that rurality is associated with lower survival rate and worse health-related quality of life (HRQOL) in survivors [5][6][7][8][9]. This apparent health disparity in breast cancer outcomes between rural and urban populations is a public health concern.…”

“…Although the incidence of breast cancer is lower in women residing in rural areas than those living in urban areas, higher mortality rates have been observed among rural women diagnosed with breast cancer [7,8,[49][50][51][52][53]. In Australia, studies using data from 1977 to 2006 have consistently shown a rural disadvantage in breast cancer mortality [6,7,53,54].…”

“…Poor access to health services and urban-rural differences in a number of individual variables have been proposed as contributory factors. Michell et al [7] used records from the Western Australia Cancer Registry to demonstrate that rural women with invasive breast cancer had 1.62 times higher 5-year mortality rate later than their urban counterparts. While age of patients and characteristics of the cancer was adjusted for in that study, other key determinants of breast cancer survival, such as socio-economic status and lifestyle factors, were not adjusted for due to the unavailability of this information in the dataset used.…”

“…Breast cancer is the most prevalent cancer in women and disparities in prognosis based on area of residence have been observed [6][7][8]. Rural areas are characterized by a low population density and often have poorer access to health care than urban areas [42].…”