Samilia Obeng-Gyasi1,2, Lava Timsina3, Oindrila Bhattacharyya4, Carla S Fisher3, David A Haggstrom5,6,7. 1. Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA. samilia.obeng-gyasi@osumc.edu. 2. Division of Surgical Oncology, The Ohio State University, Columbus, OH, USA. samilia.obeng-gyasi@osumc.edu. 3. Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA. 4. Department of Economics, Indiana University Purdue University, Indianapolis, IN, USA. 5. VA Health Services Research and Development Center for Health Information and Communication, Indianapolis, IN, USA. 6. Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN, USA. 7. Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA.
Abstract
OBJECTIVE: The purpose of this study was to examine differences in presentation, surgical management, and mortality among breast cancer patients in the National Cancer Database (NCDB) based on area of residence. METHODS: The NCDB was queried for women with a diagnosis of breast cancer from 1 January 2004-31 December 2015. The data were divided by metropolitan (large, medium, small) and non-metropolitan (urban, rural) status. RESULTS: Cancer stage increased with rurality (p < 0.0001). Residency in a large metropolitan area was associated with increased breast reconstruction rates (odds ratio [OR] 1.25, 95% confidence interval [CI] 1.19-1.30) and reduced overall mortality (hazard ratio 0.92, 95% CI 0.89-0.95) compared with rural areas. There was no difference in mastectomy use among small metropolitan (OR 1.03, 95% CI 1.01-1.04), urban (OR 0.99, 95% CI 0.98-1), and rural areas (OR 1.05, 95% CI 1.01-1.07) compared with large metropolitan areas. CONCLUSIONS: Across the rural-urban continuum in the NCDB, stage of cancer presentation increased with rurality. Conversely, residency in a large metropolitan area was associated with higher reconstruction rates and a reduction in overall mortality. Future studies should evaluate factors contributing to advanced disease presentation and lower reconstruction rates among rural breast cancer patients.
OBJECTIVE: The purpose of this study was to examine differences in presentation, surgical management, and mortality among breast cancerpatients in the National Cancer Database (NCDB) based on area of residence. METHODS: The NCDB was queried for women with a diagnosis of breast cancer from 1 January 2004-31 December 2015. The data were divided by metropolitan (large, medium, small) and non-metropolitan (urban, rural) status. RESULTS:Cancer stage increased with rurality (p < 0.0001). Residency in a large metropolitan area was associated with increased breast reconstruction rates (odds ratio [OR] 1.25, 95% confidence interval [CI] 1.19-1.30) and reduced overall mortality (hazard ratio 0.92, 95% CI 0.89-0.95) compared with rural areas. There was no difference in mastectomy use among small metropolitan (OR 1.03, 95% CI 1.01-1.04), urban (OR 0.99, 95% CI 0.98-1), and rural areas (OR 1.05, 95% CI 1.01-1.07) compared with large metropolitan areas. CONCLUSIONS: Across the rural-urban continuum in the NCDB, stage of cancer presentation increased with rurality. Conversely, residency in a large metropolitan area was associated with higher reconstruction rates and a reduction in overall mortality. Future studies should evaluate factors contributing to advanced disease presentation and lower reconstruction rates among rural breast cancerpatients.
Authors: Maria O Celaya; Ethan M Berke; Tracy L Onega; Jiang Gui; Bruce L Riddle; Sai S Cherala; Judy R Rees Journal: Rural Remote Health Date: 2010-04-23 Impact factor: 1.759
Authors: S Jane Henley; Robert N Anderson; Cheryll C Thomas; Greta M Massetti; Brandy Peaker; Lisa C Richardson Journal: MMWR Surveill Summ Date: 2017-07-07
Authors: Austin D Williams; Meghan Buckley; Robin M Ciocca; Jennifer L Sabol; Sharon L Larson; Ned Z Carp Journal: Breast Cancer Res Treat Date: 2022-01-22 Impact factor: 4.872
Authors: Ingrid M Lizarraga; Amanda R Kahl; Ellie Jacoby; Mary E Charlton; Charles F Lynch; Sonia L Sugg Journal: Breast Cancer Res Treat Date: 2021-02-13 Impact factor: 4.624
Authors: Morgan Kassabian; Samson Olowolaju; Marvellous A Akinlotan; Anna Lichorad; Robert Pope; Brandon Williamson; Scott Horel; Jane N Bolin Journal: Prev Med Rep Date: 2021-11-18
Authors: Brian L Sprague; Thomas P Ahern; Sally D Herschorn; Michelle Sowden; Donald L Weaver; Marie E Wood Journal: Prev Med Date: 2021-07-22 Impact factor: 4.018