ArticleJournal of women's health (2002)2019
Rural-Urban Residence and Stage at Breast Cancer Diagnosis Among Postmenopausal Women: The Women's Health Initiative.
Article in Journal of women's health (2002), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Social determinants of health and health inequities in breast cancer screening: a scoping review.Frontiers in public health · 2024Article
- Cumulative environmental quality is associated with breast cancer incidence differentially by summary stage and urbanicity.Scientific reports · 2023Article
- Adverse Health Outcomes among Rural and Urban Breast Cancer Survivors: A Population-Based Cohort Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2023Article
- Rural-Urban Disparities in Cancer Outcomes: Opportunities for Future Research.Journal of the National Cancer Institute · 2022Review
- Rural-Urban Differences in Breast Cancer Stage at Diagnosis.Women's health reports (New Rochelle, N.Y.) · 2022Article
- Screening High-Risk Women Veterans for Breast Cancer.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2021Article
- Environmental Quality and Invasive Breast Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2020Article
- The association of delay in curative intent treatment with survival among breast cancer patients: findings from the Women's Health Initiative.Breast cancer research and treatment · 2020Article
- Rural-Urban Residence and Stroke Risk and Severity in Postmenopausal Women: The Women's Health Initiative.Women's health reports (New Rochelle, N.Y.) · 2020Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundAlthough social exposures have complex and dynamic relationships and interactions, the existing literature on the impact of rural-urban residence on stage at breast cancer diagnosis does not examine heterogeneity of effect. We examined the joint effect of social support, social relationship strain, and rural-urban residence on stage at breast cancer diagnosis.
methodsUsing data from the Women's Health Initiative (WHI) (n = 161,808), we describe the distribution of social, behavioral, and clinical factors by rural-urban residence among postmenopausal women with incident breast cancer (n = 7,120). We used rural-urban commuting area (RUCA) codes to categorize baseline residential addresses as urban, large rural city/town, or small rural town, and the surveillance, epidemiology, and end results staging system to categorize breast cancer stage at diagnosis (dichotomized as early or late). We then used univariable and multivariable logistic regression to estimate odds ratios (ORs) and associated 95% confidence intervals (95% CI) for the relationship between rural-urban residence and stage at breast cancer diagnosis. We included separate interaction terms between rural-urban residence and social strain and social support to test for statistical interaction.
resultsOf the social, behavioral, and clinical factors we examined, only younger age at WHI enrollment screening was significantly associated with late stage at breast cancer diagnosis (p = 0.003). Contrary to our hypothesis, rural-urban residence was not significantly associated with stage at breast cancer diagnosis among postmenopausal women ([adjusted OR, 95% CI] for urban compared with small town: 1.08 [0.76-1.53]; large town compared with small town: 1.16 [0.74-1.84]; and urban compared with large town: 0.93 [0.68-1.26]).The associations did not vary by social support or social strain (p for interaction between RUCA and social strain and social support, respectively: 0.99 and 0.17).
conclusionsFuture 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.
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