ArticleMedical care2015
Predicting Late-stage Breast Cancer Diagnosis and Receipt of Adjuvant Therapy: Applying Current Spatial Access to Care Methods in Appalachia.
Article in Medical care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Influence of geographic access and socioeconomic characteristics on breast cancer outcomes: A systematic review.PloS one · 2022Pooled it
- Breast cancer screening needs assessment in 19 Northern California counties: geography, poverty, and racial/ethnic identity composition.Cancer causes & control : CCC · 2025Article
- Disparities in spatial access to neurological care in Appalachia: a cross-sectional health services analysis.Lancet regional health. Americas · 2023Article
- Tetraspanin 7 promotes osteosarcoma cell invasion and metastasis by inducing EMT and activating the FAK-Src-Ras-ERK1/2 signaling pathway.Cancer cell international · 2022Article
- Association of Community Economic Distress and Breast and Colorectal Cancer Screening, Incidence, and Mortality Rates Among US Counties.Annals of surgical oncology · 2022Article
- Spatial accessibility to colonoscopy and its role in predicting late-stage colorectal cancer.Health services research · 2021Article
- Spatial access to primary care providers and colorectal cancer-specific survival in Cook County, Illinois.Cancer medicine · 2020Article
- Change in geographic access to community health centers after Health Center Program expansion.Health services research · 2019Article
- Geographical Accessibility of Community Health Assist System General Practitioners for the Elderly Population in Singapore: A Case Study on the Elderly Living in Housing Development Board Flats.International journal of environmental research and public health · 2018Article
- Exploring neighborhood inequality in female breast cancer incidence in Tehran using Bayesian spatial models and a spatial scan statistic.Epidemiology and health · 2017Article
- Article
- Overexpression of AKIP1 predicts poor prognosis of patients with breast carcinoma and promotes cancer metastasis through Akt/GSK-3β/Snail pathway.American journal of translational research · 2016Article
- Developing a Priority Scoring Index for Mobile Mammography Sites: Considerations for Screening Access in Rural and Remote Settings.Cancer control : journal of the Moffitt Cancer CenterArticle
- Medicaid Expansion and Breast Cancer Screening in Appalachia and Non-Appalachia, United States, BRFSS 2003 to 2015.Cancer control : journal of the Moffitt Cancer CenterArticle
- Geographic disparities in adherence to adjuvant endocrine therapy in Appalachian women with breast cancer.Research in social & administrative pharmacy : RSAPArticle
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Authors and funding
6 authors.
Funding
Abstract
purposeThe 2-step floating catchment area (2SFCA) method of measuring access to care has never been used to study cancer disparities in Appalachia. First, we evaluated the 2SFCA method in relation to traditional methods. We then examined the impact of access to mammography centers and primary care on late-stage breast cancer diagnosis and receipt of adjuvant hormonal therapy.
methodsCancer registries from Pennsylvania, Ohio, Kentucky, and North Carolina were linked with Medicare data to identify the stage of breast cancer diagnosis for Appalachia women diagnosed between 2006 and 2008. Women eligible for adjuvant therapy had stage I, II, or III diagnosis; mastectomy or breast-conserving surgery; and hormone receptor-positive breast cancers. Geographically weighted regression was used to explore nonstationarity in the demographic and spatial access predictor variables.
resultsOver 21% of 15,299 women diagnosed with breast cancer had late-stage (stages III-IV) diagnosis. Predictors included age at diagnosis [odds ratio (OR)=0.86; P<0.001], insurance status (OR=1.32; P<0.001), county primary care to population ratio (OR=0.95; P<0.001), and primary-care 2SFCA score (OR=0.96; P=0.006). Only 46.9% of eligible women received adjuvant hormonal therapy, and predictors included comorbidity status (OR=1.18; P=0.047), county economic status (OR=1.32; P=0.006), and mammography center 2SFCA scores (OR=1.12; P=0.021).
conclusionsMethodologically, the 2SFCA method offered the greatest predictive validity of the access measures examined. Substantively, rates of late-stage breast cancer diagnosis and adjuvant hormonal therapy are substandard in Appalachia.
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