Record Details

Title The joint effects of census tract poverty and geographic access on late-stage breast cancer diagnosis in 10 U.S. states
Author Henry, KA
Secondary Authors Sherman R, Farber S, Cockburn M, Goldberg DW, Stroup AM
Publication Type (Help) article
Journal Health Place
Month Feb 28
Year 2013
Pages 110-121
Volume 21C
Number
Publisher
Address
Note doi: 10.1016/j.healthplace.2013.01.007
URL http://www.sciencedirect.com/science/article/pii/S1353829213000130
PubMed ID 23454732
NCI Id
EPub Date
Citation Henry KA, Sherman R, Farber S, Cockburn M, Goldberg DW, Stroup AM. The joint effects of census tract poverty and geographic access on late-stage breast cancer diagnosis in 10 U.S. states. Health Place. 2013 Feb 28;21C:110-121. PMID 23454732. [http://www.sciencedirect.com/science/article/pii/S1353829213000130.]
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Abstract

This study evaluated independent and joint effects of census tract (CT) poverty and geographic access to mammography on stage at diagnosis for breast cancer. The study included 161,619 women 40+ years old diagnosed with breast cancer between 2004 -2006 in ten participating US states. Multilevel logistic regression was used to estimate the odds of late-stage breast cancer diagnosis for the entire study population and by state. Poverty was independently associated with late-stage in the overall population (poverty rates >20% OR=1.30, 95% CI=1.26- 1.35) and for 9 of the 10 states. Geographic access was not associated with late-stage diagnosis after adjusting for CT poverty. State-specific analysis provided little evidence that geographic access was associated with breast cancer stage at diagnosis, and after adjusting for poverty, geographic access mattered in only 1 state. Overall, compared to women with private insurance, the adjusted odds ratios for late stage at diagnosis among women with either no insurance, Medicaid, or Medicare were 1.80 (95% CI = 1.65, 1.96), 1.75 (95% CI = 1.68, 1.84), and 1.05 (95% CI 1.01, 1.08), respectively. Although geographic access to mammography was not a significant predictor of late-stage breast cancer diagnosis, women in high poverty areas or uninsured are at greatest risk of being diagnosed with late-stage breast cancer regardless of geographic location and may benefit from targeted interventions.



Keywords

Keyword
breast
cancer
census
geographic
poverty