Evidence map›Paper›PMID 34302837›Full record

ArticlePreventive medicine2021

Identifying key barriers to effective breast cancer control in rural settings.

Brian L Sprague, Thomas P Ahern, Sally D Herschorn, Michelle Sowden, Donald L Weaver, Marie E Wood

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Preventive medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. 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 · 2026
    Article
  6. Leveraging Pharmacy Education through a Train-the-Trainer Model to Enhance Breast Cancer Literacy in Rural Communities.Journal of cancer education : the official journal of the American Association for Cancer Education · 2026
    Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. 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 · 2026
    Article
  14. Article
  15. Article
  16. Determinants of Female Cancer Screening Awareness in Alabama's Black Belt Region.Asian Pacific journal of cancer prevention : APJCP · 2025
    Article
  17. Article
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Brian L SpragueVermont Center on Behavior and Health, University of Vermont Larner College of Medicine, Burlington, VT, USA; Department of Surgery, University of Vermont Larner College of Medicine, Burlington, VT, USA; University of Vermont Cancer Center, University of Vermont Larner College of Medicine, Burlington, VT, USA; Department of Radiology, University of Vermont Larner College of Medicine, Burlington, VT, USA. Electronic address: bsprague@uvm.edu.
Thomas P AhernVermont Center on Behavior and Health, University of Vermont Larner College of Medicine, Burlington, VT, USA; Department of Surgery, University of Vermont Larner College of Medicine, Burlington, VT, USA; University of Vermont Cancer Center, University of Vermont Larner College of Medicine, Burlington, VT, USA.
Sally D HerschornUniversity of Vermont Cancer Center, University of Vermont Larner College of Medicine, Burlington, VT, USA; Department of Radiology, University of Vermont Larner College of Medicine, Burlington, VT, USA.
Michelle SowdenDepartment of Surgery, University of Vermont Larner College of Medicine, Burlington, VT, USA; University of Vermont Cancer Center, University of Vermont Larner College of Medicine, Burlington, VT, USA.
Donald L WeaverUniversity of Vermont Cancer Center, University of Vermont Larner College of Medicine, Burlington, VT, USA; Department of Pathology, University of Vermont Larner College of Medicine, Burlington, VT, USA.
Marie E WoodVermont Center on Behavior and Health, University of Vermont Larner College of Medicine, Burlington, VT, USA; University of Vermont Cancer Center, University of Vermont Larner College of Medicine, Burlington, VT, USA; Department of Medicine, University of Vermont Larner College of Medicine, Burlington, VT, USA.

Funding

Vermont Center on Behavior and HealthP20GM103644 · NIGMS · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI KHADANGA, SHERRIE · 2013 to 2022
$21.3M
Vermont Breast Cancer Molecular Characterization LaboratoryU01CA196383 · NCI · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI SPRAGUE, BRIAN L, STEIN, JANET L · 2015 to 2020
$5.4M
Identifying effective risk-based supplemental ultrasound screening strategies for women with dense breastsR01CA248068 · NCI · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI Diana L Miglioretti, Brian L Sprague · 2020 to 2026
$5.1M
NCI NIH HHS R01 CA248068NCI NIH HHS U01 CA196383NIGMS NIH HHS P20 GM103644
6 · The paper itself

Abstract

Breast cancer is the most common cancer and the second most common cause of cancer mortality among women in the United States. Efforts to promote breast cancer control in rural settings face specific challenges. Access to breast cancer screening, diagnosis, and treatment services is impaired by shortages of primary care and specialist providers, and geographic distance from medical facilities. Women in rural areas have comparable breast cancer mortality rates compared to women in urban settings, but this is due in large part to lower incidence rates and masks a substantial rural/urban disparity in breast cancer survival among women diagnosed with breast cancer. Mammography screening utilization rates are slightly lower among rural women than their urban counterparts, with a corresponding increase in late stage breast cancer. Differences in breast cancer survival persist after controlling for stage at diagnosis, largely due to disparities in access to treatment. Travel distance to treatment centers is the most substantial barrier to improved breast cancer outcomes in rural areas. While numerous interventions have been demonstrated in controlled studies to be effective in promoting treatment access and adherence, widespread dissemination in public health and clinical practice remains lacking. Efforts to improve breast cancer control in rural areas should focus on implementation strategies for improving access to breast cancer treatments.

Indexed as

Breast NeoplasmsEarly Detection of CancerFemaleHealth Services AccessibilityHumansMammographyRural PopulationUnited StatesUrban PopulationBreast cancercancer controlcancer preventioncancer screeningcancer treatmentRural health

Identifiers

PMID34302837
PMCPMC8545865

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.