ArticleAnnals of surgical oncology2022
Rural-Urban Differences in Breast Cancer Surgical Delays in Medicare Beneficiaries.
Article in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 26 citations in OpenAlex.
- Rurality and Income on Breast Cancer Outcomes: An Analysis of the SEER Database.Annals of surgical oncology · 2026Article
- The impact of social drivers of health on delayed time to breast cancer surgery.British journal of cancer · 2026Article
- Differences in Breast Cancer Care Between Rural Women Undergoing Treatment at a Referral Center and Those Treated Locally.Annals of surgical oncology · 2026Article
- Delay in breast cancer surgery: evaluating patient, healthcare access, and social vulnerability predictors.Cancer causes & control : CCC · 2026Article
- The rural-urban paradox: rethinking delays in breast cancer care.Gland surgery · 2026Article
- Impact of Travel Burden on Timeliness of Care and Overall Survival for Breast Cancer: A National Cancer Database Analysis.Cancer medicine · 2025Article
- The Magnitude of Delay in Non-metastatic Breast Cancer Treatment in a Tertiary Hospital: an Analysis from 2012 to 2018.Acta medica Philippina · 2025Article
- Surgeon and Care Team Network Measures and Timely Breast Cancer Treatment.JAMA network open · 2024Article
- The impact of rurality on racial disparities in costs of bowel obstruction treatment.Surgery open science · 2024Article
- Factors associated with medical students' career choice in different specialties: a multiple cross-sectional questionnaire study at a German medical school.BMC medical education · 2024Article
- The Association Between Oncology Outreach and Timely Treatment for Rural Patients with Breast Cancer: A Claims-Based Approach.Annals of surgical oncology · 2024Article
- Causes of Unwarranted Variation and Disparity in Breast Cancer Management in Regional and Rural Area.The breast journal · 2024Article
- National trends in neoadjuvant chemotherapy utilization in patients with early-stage node-negative triple-negative breast cancer: the impact of the CREATE-X trial.Breast cancer research and treatment · 2024Article
- Disparities in stage at diagnosis among breast cancer molecular subtypes in China.Cancer medicine · 2023Article
- Understanding Patient Preferences Regarding the Important Determinants of Breast Cancer Treatment: A Narrative Scoping Review.Patient preference and adherence · 2023Article
- Rurality predisposes departure from gold-standard care, leading to delayed or accelerated access to surgery: insights from a scoping review.Canadian journal of surgery. Journal canadien de chirurgieArticle
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundDelays between breast cancer diagnosis and surgery are associated with worsened survival. Delays are more common in urban-residing patients, although factors specific to surgical delays among rural and urban patients are not well understood.
methodsWe used a 100% sample of fee-for-service Medicare claims during 2007-2014 to identify 238,491 women diagnosed with early-stage breast cancer undergoing initial surgery and assessed whether they experienced biopsy-to-surgery intervals > 90 days. We employed multilevel regression to identify associations between delays and patient, regional, and surgeon characteristics, both in combined analyses and stratified by rurality of patient residence.
resultsDelays were more prevalent among urban patients (2.5%) than rural patients (1.9%). Rural patients with medium- or high-volume surgeons had lower odds of delay than patients with low-volume surgeons (odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.58-0.88; OR = 0.74, 95% CI = 0.61-0.90). Rural patients whose surgeon operated at ≥ 3 hospitals were more likely to experience delays (OR = 1.29, 95% CI = 1.01-1.64, Ref: 1 hospital). Patient driving times ≥ 1 h were associated with delays among urban patients only. Age, black race, Hispanic ethnicity, multimorbidity, and academic/specialty hospital status were associated with delays.
conclusionsSociodemographic, geographic, surgeon, and facility factors have distinct associations with > 90-day delays to initial breast cancer surgery. Interventions to improve timeliness of breast cancer surgery may have disparate impacts on vulnerable populations by rural-urban status.
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