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Spatial and Contextual Analyses of Stage at Diagnosis

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Part of the Energy Balance and Cancer book series (EBAC,volume 15)

Abstract

We assess national trends in breast cancer incidence stratified by stage at diagnosis that suggest only a limited benefit to screening mammography. We then use a novel application of the spatial scan statistic to measure spatial patterns in the breast cancer stage distribution within New York State that highlight substantial socioeconomic disparities between locales. Finally, we report stage-specific breast cancer incidence rates as a function of median household income. This last analysis indicates that the greatest difference in early-stage breast cancer rates are found between middle and upper income groups, contradicting conventional wisdom that lack of health care access among the poorer population is the main driver of socioeconomic disparities. Overall, consideration of stage at diagnosis is indispensable to conducting population-based breast cancer surveillance, assessing the efficacy of screening, and identifying geographic and socioeconomic disparities.

Keywords

  • Incidence
  • Mortality
  • Screening mammography
  • Spatial scan statistic
  • Socioeconomic status
  • New York state

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Notes

  1. 1.

    Because median household income is based on a survey of households, 58 census tracts without households (primarily college campuses, prisons, and military bases) were excluded from this part of the analysis.

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Correspondence to Francis P. Boscoe .

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Boscoe, F.P., Hutchison, L. (2019). Spatial and Contextual Analyses of Stage at Diagnosis. In: Berrigan, D., Berger, N. (eds) Geospatial Approaches to Energy Balance and Breast Cancer. Energy Balance and Cancer, vol 15. Springer, Cham. https://doi.org/10.1007/978-3-030-18408-7_13

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  • DOI: https://doi.org/10.1007/978-3-030-18408-7_13

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