ArticleHealth services research2014
Breast cancer screening, area deprivation, and later-stage breast cancer in Appalachia: does geography matter?
Article in Health services research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
46 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Understanding the effects of socioeconomic status along the breast cancer continuum in Australian women: a systematic review of evidence.International journal for equity in health · 2017Pooled it
- Guideline
- Digital Breast Tomosynthesis Use, Facility Mammography Volume, and Timely Follow-Up After Abnormal Screening Mammograms in Appalachia, United States.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Article
- Patient, facility, and community determinants of timely follow up after abnormal screening mammograms in Appalachia: A multilevel analysis.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Geospatial Analysis of Breast Cancer Incidence, Mortality, and Access to Screening in Rural and Appalachian Virginia.Journal of Appalachian health · 2025Article
- Disparities in OncotypeDx Testing and Subsequent Chemotherapy Receipt by Geography and Socioeconomic Status.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024Article
- Social determinants of health and health inequities in breast cancer screening: a scoping review.Frontiers in public health · 2024Article
- Hyperlocal disparities in breast, cervical, and colorectal cancer screening: An ecological study of social vulnerability in Miami-Dade county.Preventive medicine reports · 2023Article
- Geographic Variations and the Associated Factors in Adherence to and Persistence with Adjuvant Hormonal Therapy for the Privately Insured women Aged 18-64 with Breast Cancer in Texas.Current oncology (Toronto, Ont.) · 2023Article
- Examining Psychological and Knowledge Barriers to Colorectal Cancer Screening in Rural Appalachian Kentucky.Journal of cancer education : the official journal of the American Association for Cancer Education · 2023Article
- Piloting an Oral History Approach to Investigate Cancer Perspectives Among Residents of Appalachian Kentucky.Journal of Appalachian health · 2023Article
- Article
- Cancer disparities related to poverty and rurality for 22 top cancers in Florida.Preventive medicine reports · 2022Article
- Neighborhood disadvantage and biological aging biomarkers among breast cancer patients.Scientific reports · 2022Article
- Phenotype Discovery and Geographic Disparities of Late-Stage Breast Cancer Diagnosis across U.S. Counties: A Machine Learning Approach.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022Article
- Rural-Urban Differences in Breast Cancer Stage at Diagnosis.Women's health reports (New Rochelle, N.Y.) · 2022Article
- Sociodemographic Factors and Health Insurance Coverage Are Associated with Invasive Breast Cancer in Tennessee: Appalachian and Non-Appalachian County Comparison.Women's health reports (New Rochelle, N.Y.) · 2022Article
- Spatial analysis of colorectal cancer outcomes and socioeconomic factors in Virginia.BMC public health · 2021Article
- Geographical socioeconomic disadvantage is associated with adverse outcomes following major amputation in diabetic patients.Journal of vascular surgery · 2021Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectiveTo model the relationship of an area-based measure of a breast cancer screening and geographic area deprivation on the incidence of later stage breast cancer (LSBC) across a diverse region of Appalachia. DATA SOURCE: Central cancer registry data (2006-2008) from three Appalachian states were linked to Medicare claims and census data. STUDY
designExploratory spatial analysis preceded the statistical model based on negative binomial regression to model predictors and effect modification by geographic subregions. PRINCIPAL
findingsExploratory spatial analysis revealed geographically varying effects of area deprivation and screening on LSBC. In the negative binomial regression model, predictors of LSBC included receipt of screening, area deprivation, supply of mammography centers, and female population aged>75 years. The most deprived counties had a 3.31 times greater rate of LSBC compared to the least deprived. Effect of screening on LSBC was significantly stronger in northern Appalachia than elsewhere in the study region, found mostly for high-population counties.
conclusionsBreast cancer screening and area deprivation are strongly associated with disparity in LBSC in Appalachia. The presence of geographically varying predictors of later stage tumors in Appalachia suggests the importance of place-based health care access and risk.
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