Swann Arp Adams1,2,3, Seul Ki Choi1,4, Jan M Eberth1,2, Daniela B Friedman1,4, Mei Po Yip5, Reginald D Tucker-Seeley6,7, Lisa T Wigfall8, James R Hébert1,2. 1. 1 Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina , Columbia, South Carolina. 2. 2 Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina , Columbia, South Carolina. 3. 3 College of Nursing, University of South Carolina , Columbia, South Carolina. 4. 4 Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina , Columbia, South Carolina. 5. 5 Division of General Internal Medicine, University of Washington , Seattle, Washington. 6. 6 Center for Community Based Research, Dana-Farber Cancer Institute , Boston, Massachusetts. 7. 7 Department of Social and Behavioral Sciences, Harvard School of Public Health , Boston, Massachusetts. 8. 8 Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina , Columbia, South Carolina.
Abstract
OBJECTIVE: Mammography is the most effective method to detect breast cancer in its earliest stages, reducing the risk of breast cancer death. We investigated the relationship between accessibility of mammography services at Federally Qualified Health Centers (FQHCs) and mortality-to-incidence ratio (MIR) of breast cancer in each county in the United States. METHODS: County-level breast cancer mortality and incidence rates in 2006-2010 were used to estimate MIRs. We compared breast cancer MIRs based on the density and availability of FQHC delivery sites with or without mammography services both in the county and in the neighboring counties. RESULTS: The relationship between breast cancer MIRs and access to mammography services at FQHCs differed by race and county of residence. Breast cancer MIRs were lower in counties with mammography facilities or FQHC delivery sites than in counties without a mammography facility or FQHC delivery site. This trend was stronger in urban counties (p=0.01) and among whites (p=0.008). Counties with a high density of mammography facilities had lower breast cancer MIRs than other counties, specifically in urban counties (p=0.01) and among whites (p=0.01). Breast cancer MIR for blacks was the lowest in counties having mammography facilities; and was highest in counties without a mammography facility within the county or the neighboring counties (p=0.03). CONCLUSIONS: Mammography services provided at FQHCs may have a positive impact on breast cancer MIRs. Expansion of services provided at the FQHCs and placement of FQHCs in additional underserved areas might help to reduce cancer disparities in the United States.
OBJECTIVE: Mammography is the most effective method to detect breast cancer in its earliest stages, reducing the risk of breast cancer death. We investigated the relationship between accessibility of mammography services at Federally Qualified Health Centers (FQHCs) and mortality-to-incidence ratio (MIR) of breast cancer in each county in the United States. METHODS: County-level breast cancer mortality and incidence rates in 2006-2010 were used to estimate MIRs. We compared breast cancer MIRs based on the density and availability of FQHC delivery sites with or without mammography services both in the county and in the neighboring counties. RESULTS: The relationship between breast cancer MIRs and access to mammography services at FQHCs differed by race and county of residence. Breast cancer MIRs were lower in counties with mammography facilities or FQHC delivery sites than in counties without a mammography facility or FQHC delivery site. This trend was stronger in urban counties (p=0.01) and among whites (p=0.008). Counties with a high density of mammography facilities had lower breast cancer MIRs than other counties, specifically in urban counties (p=0.01) and among whites (p=0.01). Breast cancer MIR for blacks was the lowest in counties having mammography facilities; and was highest in counties without a mammography facility within the county or the neighboring counties (p=0.03). CONCLUSIONS: Mammography services provided at FQHCs may have a positive impact on breast cancer MIRs. Expansion of services provided at the FQHCs and placement of FQHCs in additional underserved areas might help to reduce cancer disparities in the United States.
Authors: Kristen J Wells; John S Luque; Branko Miladinovic; Natalia Vargas; Yasmin Asvat; Richard G Roetzheim; Ambuj Kumar Journal: Cancer Epidemiol Biomarkers Prev Date: 2011-06-08 Impact factor: 4.254
Authors: Elizabeth Tarlov; Shannon N Zenk; Richard T Campbell; Richard B Warnecke; Richard Block Journal: J Urban Health Date: 2008-10-30 Impact factor: 3.671
Authors: Swann A Adams; Suel Ki Choi; Jan M Eberth; Heather M Brandt; Daniela B Friedman; James R Hébert Journal: Am J Public Health Date: 2016-06 Impact factor: 9.308
Authors: James R Hébert; Swann Arp Adams; John R Ureda; Vicki M Young; Heather M Brandt; Sue P Heiney; Jessica S Seel; Daniela B Friedman Journal: Public Health Rep Date: 2017-11-28 Impact factor: 2.792
Authors: Swann Arp Adams; Catherine L Rohweder; Jennifer Leeman; Daniela B Friedman; Ziya Gizlice; Robin C Vanderpool; Natoshia Askelson; Alicia Best; Susan A Flocke; Karen Glanz; Linda K Ko; Michelle Kegler Journal: J Community Health Date: 2018-12
Authors: Jan M Eberth; Whitney E Zahnd; Swann Arp Adams; Daniela B Friedman; Stephanie B Wheeler; James R Hébert Journal: Prev Med Date: 2019-11-01 Impact factor: 4.018