ArticleCancer causes & control : CCC2025
Persistent poverty and late-stage breast cancer diagnosis in the USA: impacts of rural residence, race, and time within Surveillance, Epidemiology, and End Results registries, 2004 to 2021.
Article in Cancer causes & control : CCC, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Global patterns, temporal trends and socioeconomic inequalities in the burden of breast cancer: a population-based study across 185 countries.Cancer biology & medicine · 2026Article
- Persistent poverty and breast cancer incidence by tumor subtype: intersections of rural/urban residence and race within USA Surveillance Epidemiology and End Results Registries, 2017 to 2021.Cancer causes & control : CCC · 2026Article
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Abstract
backgroundCounty-level poverty is associated with higher rates of late-stage breast cancer (LSBC). The role of persistent poverty (> 20% residents in poverty for 30 + years) in breast cancer stage at diagnosis is unclear and may vary by rural/urban status, race, and over time.
methodsWe analyzed county-level data from the Surveillance, Epidemiology, and End Results Program for females (ages 20-74 years) with late-stage (regional and distant) breast cancer from 2017 to 2021 (excluding 2020). We estimated mean rate differences (RDs) in LSBC between persistently poor (n = 156) and non-persistently poor (n = 923) counties using multivariable linear regression models stratified by rural/urban status and race. We used Joinpoint regression analysis to estimate overall annual percent changes (APC) in breast cancer rates by stage from 2004 to 2019, as well as by persistent poverty and rural/urban status.
resultsAge-adjusted LSBC rates were higher in persistently poor counties, but differences were diminished in multivariable models (RD = 2.74, 95% CI - 1.6, 7.1). Adjusted results did not differ based on rural/urban status (p
conclusionElevated LSBC rates in persistent poverty counties are largely explained by recent poverty and race/ethnicity. Given the rising rates of LSBC in persistent poverty counties, our findings emphasize the importance of addressing breast cancer screening barriers among disadvantaged populations.
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