ArticleWomen's health issues : official publication of the Jacobs Institute of Women's Health
Urban/Rural Differences in Breast and Cervical Cancer Incidence: The Mediating Roles of Socioeconomic Status and Provider Density.
Article in Women's health issues : official publication of the Jacobs Institute of Women's Health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers.
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Who cites it
61 citing papers in PubMed.
- Self-sampling tools to increase cancer screening among underserved patients: a pilot randomized controlled trial.JNCI cancer spectrum · 2024Trial
- Prognostic value of the nutritional risk index and prognostic nutritional index for immunotherapy outcomes in cervical Cancer.Gynecologic oncology reports · 2026Article
- Article
- Mammography screening in Tennessee: a tract-level spatial analysis of geographic and socioeconomic disparities.Cancer causes & control : CCC · 2026Article
- The Effect of Social Associations on Mammography Screening Disparities in Rural Communities: A County-Level Secondary Analysis.Cancer medicine · 2026Article
- Factors associated with breast cancer screening among insured and uninsured women in Tanzania: an analysis of the Tanzania demographic and health survey 2022.Health economics review · 2026Article
- Incorporating small-area estimation into mediation analyses with areal datasets.Spatial and spatio-temporal epidemiology · 2025Article
- Breast cancer mortality in Romania: trends, regional and rural-urban inequalities, and policy implications.BMC cancer · 2025Article
- The Influence of Residential Segregation, Urbanicity, and Population Density on Hepatocellular Carcinoma Incidence among a Low Socioeconomic Population.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Temporal trends of cervical cancer demographics: a CDC WONDER database study.Frontiers in oncology · 2025Article
- Correlates associated with health insurance on cervical cancer screening in Tanzania: a comparison between the insured and uninsured women using demographic and health survey 2022.BMC health services research · 2024Article
- Medicaid expansion in California and breast cancer incidence across neighborhoods with varying social vulnerabilities.Cancer causes & control : CCC · 2024Article
- Comparing Cervical Cancer Screening Strategies in an Incarcerated Population.Journal of women's health (2002) · 2024Article
- Persistent poverty disparities in incidence and outcomes among oral and pharynx cancer patients.Cancer causes & control : CCC · 2024Article
- Cervical cancer trend in the Republic of Kazakhstan and attitudes towards cervical cancer screening in urban and rural areas.Scientific reports · 2024Article
- Cervical Cancer Screening Rates Among Rural and Urban Females, From 2019 to 2022.JAMA network open · 2024Article
- Health Literacy, Individual and Community Engagement, and Cardiovascular Risks and Disparities:JACC. CardioOncology · 2024Review
- Factors Associated with Abnormal Mammogram Results Among Low-Income Uninsured Populations in Medically Underserved And Rural Texas Regions.Women's health reports (New Rochelle, N.Y.) · 2024Article
- Article
- Malignant neoplasms of the vagina: A 30-year review from the Republic of Belarus.Gynecologic oncology reports · 2023Article
1 more citing papers are in PubMed but not listed here.
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Authors and funding
3 authors.
Funding
Abstract
backgroundBreast and cervical cancer incidence vary by urbanicity, and several ecological factors could contribute to these patterns. In particular, cancer screening or other sociodemographic and health care system variables could explain geographic disparities in cancer incidence.
methodsGovernmental and research sources provided data on 612 counties in the Surveillance, Epidemiology, and End Results program for rural-urban continuum code, socioeconomic status (SES) quintile, percent non-Hispanic White residents, density of primary care physicians, cancer screening, and breast and cervical cancer incidence rates (2009-2013). Ecological mediation analyses used weighted least squares regression to examine whether candidate mediators explained the relationship between urbanicity and cancer incidence.
resultsAs urbanicity increased, so did breast cancer incidence (βˆ = 0.23; p < .001). SES quintile and density of primary care physicians mediated this relationship, whereas percent non-Hispanic White suppressed it (all p < .05); county-level mammography levels did not contribute to the relationship. After controlling for these variables, urbanicity and breast cancer incidence were no longer associated (βˆ = 0.11; p > .05). In contrast, as urbanicity increased, cervical cancer incidence decreased (βˆ = -0.33; p < .001). SES quintile and density of primary care physicians mediated this relationship (both p < .05); percent non-Hispanic White and Pap screening levels did not contribute to the relationship. After controlling for these variables, the relationship between urbanicity and cervical cancer incidence remained significant (βˆ = -0.13; p < .05).
conclusionsCounty-level SES and density of primary care physicians explained the relationships between urbanicity and breast and cervical cancer incidence. Improving these factors in more rural counties could ameliorate geographic disparities in breast and cervical cancer incidence.
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