Rural–Urban Residence and Stage at Breast Cancer Diagnosis Among Postmenopausal Women: The Women's Health Initiative

Sealy-Jefferson, Shawnita; Roseland, Molly E.; Coté, Michele L.; Lehman, Amy; Whitsel, Eric A.; Mustafaa, Faheemah N.; Booza, Jason; Simon, Michael S.

doi:10.1089/jwh.2017.6884

Cited by 15 publications

(21 citation statements)

References 41 publications

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“…9,[59][60][61][62] In contrast, other studies have shown that rurality or travel distance have an inverse or no association with late diagnosis. 6,14,63,64 In several countries, rural regions tend to have more socio-economic disadvantage than urban regions. [65][66][67] Moreover, other studies have found that rural regions have higher prevalence of physical inactivity, obesity, smoking, alcohol consumption, and chronic diseases, often related to socio-economic deprivation.…”

Section: Discussionmentioning

confidence: 99%

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Rural–urban residence and cancer survival in high‐income countries: A systematic review

Afshar

English

Milne

2019

Cancer

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There is some evidence that place of residence is associated with cancer survival, but the findings are inconsistent, and the underlying mechanisms by which residential location might affect survival are not well understood. We conducted a systematic review of observational studies investigating the association of rural versus urban residence with cancer survival in high‐income countries. We searched the Ovid Medline, EMBASE, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases up to May 31, 2016. Forty‐five studies published between 1984 and 2016 were included. We extracted unadjusted and adjusted relative risk estimates with the corresponding 95% confidence intervals. Most studies reported worse survival for cancer patients living in rural areas than those in urban regions. The most consistent evidence, observed across several studies, was for colorectal, lung, and prostate cancer. Of the included studies, 18 did not account for socio‐economic position. Lower survival for more disadvantaged patients is well documented; therefore, it could be beneficial for future research to take socio‐economic factors into consideration when assessing rural/urban differences in cancer survival. Some studies cited differential stage at diagnosis and treatment modalities as major contributing factors to regional inequalities in cancer survival. Further research is needed to disentangle the mediating effects of these factors, which may help to establish effective interventions to improve survival for patients living outside major cities.

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Section: Discussionmentioning

confidence: 99%

“…Several studies that have assessed rural/urban differences have found that rural patients present with more advanced disease stage . In contrast, other studies have shown that rurality or travel distance have an inverse or no association with late diagnosis …”

Section: Discussionmentioning

confidence: 99%

Rural–urban residence and cancer survival in high‐income countries: A systematic review

Afshar

English

Milne

2019

Cancer

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“…30 U.S. Census tracts provide more granular information about neighborhoods than larger county definitions. 11 Study participant addresses were geocoded as previously described, [31][32][33] and assigned a tract-level, RUCA code based on a reference document from the United States Department of Agriculture. 30 Our analytic sample included 155,186 women whose addresses were linkable Sealy-Jefferson, et al; Women's Health Report 2020, 1.1 http://online.liebertpub.com/doi/10.1089/whr.2020.0034 to the RUCA coding scheme £2 years after they were randomized in the clinical trials or enrolled in the observational study.…”

Section: Rural-urban Classificationmentioning

confidence: 99%

Rural–Urban Residence and Stroke Risk and Severity in Postmenopausal Women: The Women's Health Initiative

Sealy-Jefferson

Roseland

Coté

et al. 2020

Women's Health Reports

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Background: The impact of rural-urban residence on stroke risk and poor stroke outcomes among postmenopausal women is unknown. Methods: We used data from the Women's Health Initiative (WHI) (1993-2014; n = 155,186) to test the hypothesis that women who live in rural compared with urban areas have higher stroke risk and worse stroke outcomes than urban women. We used rural-urban commuting area codes to categorize geocoded participant addresses into urban, large rural, or small rural areas. Incident strokes during follow-up were adjudicated by neurologists who used standardized criteria for reviewing brain imaging reports and other medical records and determining stroke subtype. Stroke functional recovery was measured with the Glasgow Stroke Outcomes Scale ascertained from the hospital record. We used univariable and multivariable-adjusted Cox proportional hazards models as well as logistic regression models to test whether rural-urban residence predicted stroke risk and odds of poor stroke outcome. Results: Among the 155,186 women in our cohort, 2.3% (n = 3514) had an incident stroke. We observed a modest reduction in risk of incident stroke among women who lived in urban (adjusted hazard ratio [aHR]: 0.86, confidence interval [95% CI]: 0.71-1.05) and large rural areas (aHR: 0.79, 95% CI: 0.60-1.04) compared with women who lived in small rural areas. In contrast, women who lived in urban compared with large rural areas had a similarly modest increased risk of stroke (aHR: 1.09, 95% CI: 0.89-1.32). Women who lived in urban compared with large rural areas were more likely to have poor stroke outcome (odds ratio [OR]: 1.41, 95% CI: 1.06-1.88), but the association was attenuated after adjustment for covariates (adjusted OR [aOR]: 1.27, 0.93-1.74). Conclusions: Future studies should confirm and examine the potential pathways of the reported associations among postmenopausal women.

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“…Socioeconomic status affects the treatment of breast cancer sufferers. Including geographic areas [25]. Residents in metropolitan areas have better disease improvement rates as well as lower mortality rates.…”

Section: Discussionmentioning

confidence: 99%

Literature Review: Social Determinant of Health in Breast Cancer Patients Survival

Azriful

Mallapiang

Kurniati

2021

Open Access Maced J Med Sci

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BACKGROUND: Social determinants have an important role in the survival of breast cancer patients. AIM: This article aims to reviews the social determinants that affect the survival of breast cancer patient. METHODS: We searched PubMed and Google Scholar for identifying studies related to this review using free-text terms and Medical Subject Headings terms. Both experimental and observational studies on social determinants of breast cancer patient survival which were published in the English language have been included in this review except expert opinions, commentaries, editorials, and review articles. Ten studies were eligible to be included in review. RESULTS: Social health determinants that play a role in the survival of breast cancer patients are education level, place of residence, socioeconomic status, social environment, racial discrimination, and access to health services. CONCLUSION: Social determinants have an influence on the survival of breast cancer patients, so it is important to pay attention to these factors.

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Rural–Urban Residence and Stage at Breast Cancer Diagnosis Among Postmenopausal Women: The Women's Health Initiative

Abstract: Future studies should examine other potential effect modifiers to identify novel factors predictive or protective for late stage at breast cancer diagnosis associated with rural-urban residence.

Cited by 15 publications

References 41 publications

Rural–urban residence and cancer survival in high‐income countries: A systematic review

Rural–urban residence and cancer survival in high‐income countries: A systematic review

Rural–Urban Residence and Stroke Risk and Severity in Postmenopausal Women: The Women's Health Initiative

Literature Review: Social Determinant of Health in Breast Cancer Patients Survival

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