Disparity in Breast Cancer Late Stage at Diagnosis in Missouri: Does Rural Versus Urban Residence Matter?
Disparity in Breast Cancer Late Stage at Diagnosis in Missouri: Does Rural Versus Urban Residence Matter?
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DOI：
10.1007/s40615-015-0132-9
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发表时间：
2016-06
影响因子：
3.9
通讯作者：
Thompson E
中科院分区：
文献类型：
--
作者：
Williams F;Thompson E
尽管与白人女性相比，黑人女性的乳腺癌发病率较低，但黑人女性的死亡率高于其他任何群体。我们使用密苏里州所有115个县的基于人口的乳腺癌发病率，按种族和地理区域检查了乳腺癌的表现阶段。我们使用了密苏里州癌症登记和研究中心2003-2008年的乳腺癌发病率数据。居住的县使用城乡连续体代码被分类为城市或农村。我们根据种族和大都市状况计算诊断阶段的条件比例，并使用皮尔逊卡方检验和耶茨连续性校正来确定相关性的统计学意义。研究结果表明，与白人女性(30.2%)相比，黑人女性(38.8%)被诊断为更晚期的乳腺癌转移的比例更高。我们的结果进一步表明，诊断阶段取决于居住地或大都市状况(p=0.04)。居住在非大都市县的女性患晚期乳腺癌的可能性略高于大都市女性(32.0%对30.7%)。总体而言，黑人女性被诊断为晚期乳腺癌的几率是白人女性的1.5倍(OR=1.5；95%CI，1.39，1.63；p<；0.0001)。而居住在非大都市或农村的女性晚期确诊的几率比大都市或城市的女性高11%以上。目前的研究证实了先前的发现，即居住在非大都市农村县的妇女被诊断为晚期乳腺癌的风险更高。
Despite the fact that black women have a lower incidence of breast cancer compared to white women, black women experience higher death rates than any other group. We examined the stage of breast cancer presentation by race and geographic region using population-based breast cancer incidence in all 115 counties in the state of Missouri. We used 2003–2008 breast cancer incidence data from Missouri Cancer Registry and Research Center. County of residence was categorized as urban or rural using the rural–urban continuum code. We computed the conditional proportion of stage at diagnosis by race and metropolitan status and also used Pearson’s chi-squared test with Yates’ continuity correction to determine statistical significance of association. Results of the study indicate that a greater proportion of black women (38.8 %) compared to white women (30.2 %) were diagnosed with more advanced breast metastasis. Our results further suggest that stage at diagnosis depended on county of residence or metropolitan status (p = .04). Women living in non-metropolitan counties were slightly more likely to have late-stage breast cancer than their metropolitan counterparts (32.0 vs 30.7 %). Overall, black women had 1.5-fold increased odds of late-stage breast cancer diagnosis compared to their white counterparts (OR = 1.50; 95 % CI, 1.39, 1.63; p < 0.0001). While the odds of late diagnosis among women living in non-metropolitan or rural counties was over 11 % higher compared with their metropolitan or urban counterpart. The current study corroborates previous findings that the risk of late-stage breast cancer diagnosis was higher among women residing in non-metropolitan rural counties.
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影响因子：
3.4
作者：
Chien LC;Yu HL;Schootman M
通讯作者：
Schootman M
影响因子：
2.6
作者：
Ess, S.;Savidan, A.;Thuerlimann, B.
通讯作者：
Thuerlimann, B.
加州农村和城市居民的早期癌症检测。
影响因子：
4.5
作者：
Blair, Sarah L.;Sadler, Georgia R.;Bristol, Rebecca;Summers, Courtney;Tahar, Zanera;Saltzstein, Sidney L.
通讯作者：
Saltzstein, Sidney L.
影响因子：
4.8
作者：
Henry, Kevin A.;Sherman, Recinda;Roche, Lisa M.
通讯作者：
Roche, Lisa M.
影响因子：
1.9
作者：
Cho, Young Ik;Johnson, Timothy P.;Warnecke, Richard B.
通讯作者：
Warnecke, Richard B.