Skip to main content
SpringerLink
Log in
Book cover

Geospatial Approaches to Energy Balance and Breast Cancer pp 379–398Cite as

Rural-Urban Disparities in Breast Cancer: Six Suppositions and Future Directions

  • Chapter
  • First Online:

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

Abstract

Disparities in breast cancer outcomes between rural and urban populations are of great interest as environmental, social, and technological processes unevenly affect rural and urban landscapes. This chapter examines research on rural-urban disparities in breast cancer. The first section briefly reviews recent literature on variations in breast cancer incidence, stage, survival, quality of life, treatment and costs in rural and urban areas. The next section critically evaluates this work by presenting six suppositions about rural and urban places and populations. Each supposition discusses a key issue concerning how rural and urban categories and disparities are defined, measured, and analyzed. I argue that rural and urban are complex, heterogeneous categories that are difficult to define and that change over time complicates our understanding of breast cancer disparities. The complexity, heterogeneity, and dynamism of urban and rural places and populations give rise to unequal and varying BC outcomes. In addition, people’s differing experiences of urban and rural places strongly influence important risks and exposures, while also affecting access to diagnosis and treatment facilities, leading to people- and place-based heterogeneity in breast cancer outcomes. Implications for future research on rural-urban disparities are discussed.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Ahmad F, Mahmood S, Pietkiewicz I, et al. Concept mapping with South Asian immigrant women: barriers to mammography and solutions. J Immigr Minor Healt. 2012;14(2):242–50.

    Article  Google Scholar 

  2. Alford-Teaster J, Lange JM, Hubbard RA, et al. Is the closest facility the one actually used? An assessment of travel time estimation based on mammography facilities. Int J Health Geogr. 2016;15:8. https://doi.org/10.1186/s12942-016-0039-7.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Anderson RT, Yang T-C, Matthews SA, et al. Breast cancer screening, area deprivation, and later-stage breast cancer in appalachia: does geography matter? Health Serv Res. 2014;49:546–67. https://doi.org/10.1111/1475-6773.12108.

    Article  PubMed  Google Scholar 

  4. Arrington AK, Kruper L, Vito C, et al. Rural and urban disparities in the evolution of sentinel lymph node utilization in breast cancer. Am J Surg. 2013;206:674–81.

    Article  PubMed  Google Scholar 

  5. Benmanian A, Beyer KMM. Measures matter: the local exposure/isolation (Lex/Is) metrics and relationships between local-level segregation and breast cancer survival. Cancer Epidemiol Biomark Prev. 2017;26(4):516–24.

    Article  Google Scholar 

  6. Beyer KMM, Zhou Y, Matthews K, et al. Breast and colorectal cancer survival disparities in Southeastern Wisconsin. Wis Med J. 2016a;115(1):17–21.

    Google Scholar 

  7. Beyer KMM, Zhou Y, Matthews K, et al. New spatially continuous indices of redlining and racial bias in mortgage lending: links to survival after breast cancer diagnosis and implications for health disparities research. Health Place. 2016b;40:34–43.

    Article  PubMed  Google Scholar 

  8. Blake KD, Moss JL, Gaysynsky A, et al. Making the case for investment in rural cancer control: an analysis of rural cancer incidence, mortality, and funding trends. Cancer Epidemiol Biomark Prev. 2017;26:992–7. https://doi.org/10.1158/1055-9965.EPI-17-0092.

    Article  Google Scholar 

  9. Blair SL, Sadler GR, Bristol R, Summers C, Tahir Z, Saltzstein SL (2006) , Early cancer detection among rural and urban Californians. BMC Public Health, 6:194. https://doi.org/10.1186/1471-2458-6-194

  10. Boscoe FP, Johnson CJ, Henry KA, Goldberg DW, Shahabi K, Elkin EB, Ballas LK, Cockburn M. Geographic proximity to treatment for early stage breast cancer and likelihood of mastectomy. Breast. 2011;20:324–8. PMID: 21440439

    Article  PubMed  Google Scholar 

  11. Celaya MO, Berke EM, Onega TL, Gui J, Riddle BL, Sherala SS, Rees JR. Breast cancer stage at diagnosis and geographic access to mammography screening (New Hampshire, 1998–2004). Rural Remote Health. 2010;10(2):1361. PMID: 20438282

    PubMed  PubMed Central  Google Scholar 

  12. Chandak A, Nayar P, Lin G. Rural-urban disparities in access to breast cancer screening: a spatial clustering analysis. J Rural Health. 2018;35:229–35. https://doi.org/10.1111/jrh.12308.

    Article  PubMed  Google Scholar 

  13. Cohen SA, Kelley L, Bell AE. Spatiotemporal discordance in five common measures of rurality for US counties and applications for health disparities research in older adults. Front Public Health. 2015;3:267. https://doi.org/10.3389/fpubh.2015.00267.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Cromartie J. Rural areas show overall population decline and shifting regional patterns of population change. Amber waves, 2017 Available at: /www.ers.usda.gov/amber-waves/2017/september/rural-areas-show-overall-population-decline-and-shifting-regional-patterns-of-population-change/

  15. Crouch E, Eberth JM, Probst JC, et al. Rural-urban differences in costs of end-of-life care for the last 6 months of life among patients with breast, lung, or colorectal cancer. J Rural Health. 2018;35:199–207. https://doi.org/10.1111/jrh.12301.

    Article  PubMed  Google Scholar 

  16. Cummins S, Curtis S, Diez-Roux AV, et al. Understanding and representing ‘place’ in health research: a relational approach. Soc Sci Med. 2007;65:1825–38.

    Article  PubMed  Google Scholar 

  17. Dai D. Black residential segregation, disparities in spatial access to health care facilities, and late-stage breast cancer diagnosis in metropolitan Detroit. Health Place. 2010;16:1038–52.

    Article  PubMed  Google Scholar 

  18. Doescher MP, Jackson JE. Trends in cervical and breast cancer screening practices among women in rural and urban areas of the United States. J Public Health Manag Pract. 2009;15:200–9.

    Article  PubMed  Google Scholar 

  19. Gangnon RE, Sprague BL, Stout NK, et al. The contribution of mammography screening to breast cancer incidence trends in the united states: an updated age-period-cohort model. Cance Epidemiol Biomark Prev. 2015;24:905–12. https://doi.org/10.1158/1055-9965.EPI-14-1286.

    Article  Google Scholar 

  20. Ghose R. Big sky or big sprawl? Rural gentrification and the changing cultural landscape of Missoula, Montana. Urban Geogr. 2004;25(6):528–49.

    Article  Google Scholar 

  21. Gilbert PA, Larouche HH, Wallace RB, Parker EA, Curry SJ. Extending work on rural health disparities: a commentary on Matthews and colleagues’ report. J Rural Health. 2018;34:119–21.

    Article  PubMed  Google Scholar 

  22. Halfacree KH. Locality and social representation: space, discourse and alternative definitions of the rural. J Rural Stud. 1993;9:23–37.

    Article  Google Scholar 

  23. Hall SA, Kaufman JS, Ricketts TL. Defining urban and rural areas in U.S. epidemiologic studies. J Urban Health. 2006;85:162–75.

    Article  Google Scholar 

  24. Hashibe M, Kirchoff AC, Kepka D, et al. Disparities in cancer survival and incidence by metropolitan versus rural residence in Utah. Cancer Med. 2018;7(4):1490–7.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Hart LG, Larson EH, Lishner DM. Rural definitions for health policy and research. Am J Public Health. 2005;95(7):1149–55.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Heley J, Jones L. Relational rural: some thoughts on relating things and theory in rural studies. J Rural Stud. 2012;28(3):208–17.

    Article  Google Scholar 

  27. Henley SJ, Anderson RN, Thomas CC, et al. Invasive cancer incidence, 2004–2013, and deaths, 2006–2015, in nonmetropolitan and metropolitan counties – United States. MMWR. 2017;66(14)

    Article  PubMed Central  Google Scholar 

  28. Henry KA, Boscoe FP, Johnson CJ, et al. Breast cancer stage at diagnosis: is travel time important? J Community Health. 2011;36:933–42, PMID: 21461957.

    Article  PubMed  Google Scholar 

  29. Henry KA, Sherman R, Farber S, et al. The joint effects of census tract poverty and geographic access on late-stage breast cancer diagnosis in 10 US States. Health Place. 2013;21:110–21, PMID: 23454732.

    Article  PubMed  Google Scholar 

  30. Jacquez GM, Kaufmann A, Meliker J, et al. Global, local and focused clustering for case-control data with residential histories. Environ Health. 2005;4:4.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Isserman A. In the national interest: defining rural and urban correctly in research and public policy. Int Reg Sci Rev. 2005;28(4):465–99.

    Article  Google Scholar 

  32. Jacobs LK, Kelley KA, Rosson GD, et al. Disparities in urban and rural mastectomy populations: the effects of patient- and county-level factors on likelihood of receipt of mastectomy. Ann Surg Oncol. 2008;15:2644–52.

    Article  PubMed  Google Scholar 

  33. Kolor K, Chen Z, Grosse SD, et al. BRCA genetic testing and receipt of preventive interventions among women aged 18–64 years with employer-sponsored health insurance in nonmetropolitan and metropolitan areas – United States 2009–2014. MMWR. 2017;66(15):1–11.

    PubMed  PubMed Central  Google Scholar 

  34. Kuo TM, Mobley LR, Anselin L. Geographic disparities in late-stage breast cancer diagnosis in California. Health Place. 2011;17(1):327–34.

    Article  PubMed  Google Scholar 

  35. Kwan M. The uncertain geographic context problem. Ann Am Assoc Geogr. 2012;102:958–68. https://doi.org/10.1080/00045608.2012.687349.

    Article  Google Scholar 

  36. Leung J, McKenzie S, Martin J, McLaughlin D. Effect of rurality on screening for breast cancer: a systematic review and meta-analysis comparing mammography. Rural Remote Health. 2014;14:2730.

    CAS  PubMed  Google Scholar 

  37. MacKinnon JA, Duncan RC, Huang Y, et al. Detecting an association between socioeconomic status and late stage breast cancer using spatial analysis and area-based measures. Cancer Epidemiol Biomark Prev. 2007;16:756–62. https://doi.org/10.1158/1055-9965.EPI-06-0392.

    Article  Google Scholar 

  38. Macintyre S, Ellawa A, Cummins S. Place effects on health: how can we conceptualize, operationalize and measure them? Soc Sci Med. 2002;55:125–39. https://doi.org/10.1016/S0277-9536(01)00214-3.

    Article  PubMed  Google Scholar 

  39. Mao L, Yang J, Deng G. Mapping rural-urban disparities in late-stage cancer with high-resolution rurality index and GWR. Spat Spatio Temporal Epidemiol. 2018;28:15–23.

    Article  Google Scholar 

  40. McLafferty S, Wang F, Luo L, Butler J. Rural-urban inequalities in late-stage breast cancer: spatial and social dimensions of risk and access. Environ Plann B Plann Des. 2011;38:726–40.

    Article  PubMed  PubMed Central  Google Scholar 

  41. McNulty JA, Nail L. Cancer survivorship in rural and urban adults: a descriptive and mixed methods study. J Rural Health. 2015;31:282–91.

    Article  PubMed  Google Scholar 

  42. Meilleur A, Subramanian SV, Plascak JJ, Fisher JL, Paskett ED, Lamont EB. Rural residence and cancer outcomes in the U.S.: issues and challenges. Cancer Epidemiol Biomark Prev. 2013;22(10):1657–67. https://doi.org/10.1158/1055-9965.EPI-13-0404.

    Article  Google Scholar 

  43. Mobley LR, Kuo TM, Watson L, et al. Geographic disparities in late-stage cancer diagnosis: multilevel factors and spatial interactions. Health Place. 2012;18:978–90.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Mobley LR, Kuo T-M, Scott L, Rutherford Y, Bose S. Modeling geospatial patterns of late-stage diagnosis of breast cancer in the US. Int J Environ Res Public Health. 2017;14(5):484. https://doi.org/10.3390/ijerph14050484.

    Article  PubMed Central  Google Scholar 

  45. Mobley LR, Kuo T-M. Demographic disparities in late-stage diagnosis of breast and colorectal cancers across the USA. J Racial Ethn Health Disparities. 2017;4:201–12.

    Article  PubMed  Google Scholar 

  46. Moss JL, Liu B, Feuer EJ. Urban/rural differences in breast and cervical cancer incidence: the mediating roles of socioeconomic status and provider density. Womens Health Issues. 2017;27(6):683–91.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Nguyen-Pham S, Leung J, McLaughlin D. Disparities in breast cancer stage at diagnosis in urban and rural adult women: a systematic review and meta-analysis. Ann Epidemiol. 2014;24:228–35.

    Article  PubMed  Google Scholar 

  48. Nordberg RB, Meliker JR, Ersball AK, Jacquez GM, Poulsen AH, Raaschou-Nielsen O. Space-time clusters of breast cancer using residential histories: a Danish case-control study. BMC Cancer. 2013;14:255. https://doi.org/10.1186/1471-2407-14-255.

    Article  Google Scholar 

  49. Parise CA, Caggiano V. Regional variation in disparities in breast cancer specific mortality due to race/ethnicity, socioeconomic status, and urbanization. J Racial Ethn Health Disparities. 2017;4:706–17.

    Article  PubMed  Google Scholar 

  50. Peipins LA, Graham S, Young R, Lewis B, Foster S, Flanagan B, Dent A. Time and distance barriers to mammography facilities in the Atlanta metropolitan area. J Community Health. 2011;36(4):675–83.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Pruitt SL, Eberth JM, Morris ES, Grinsfelder DB, Cuate EL. Rural-urban differences in late-stage breast cancer: do associations differ by rural-urban classification system? Tex Public Health J. 2015;67(2):19–27.

    PubMed  PubMed Central  Google Scholar 

  52. Reid-Arndt SA, Cox CR. Does rurality affect quality of life following treatment for breast cancer? J Rural Health. 2010;26(4):402–5.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Rust G, Zhang S, Khusdeep M, Reese L, McRoy L, Baltrus P, Caplan L, Levine R. Paths to health equity: local area variation in progress toward eliminating breast cancer mortality disparities, 1990–2009. Cancer. 2015;121(16):2765–74.

    Article  PubMed  Google Scholar 

  54. Schootman M, Aft R. Rural-urban differences in radiation therapy for ductal carcinoma in-situ of the breast. Breast Cancer Res Treat. 2001;68(2):117–25.

    Article  CAS  PubMed  Google Scholar 

  55. Schootman M, Jeffe DB, Lian M, et al. The role of poverty rate and racial distribution in the geographic clustering of breast cancer survival among older women: a geographic and multilevel analysis. Am J Epidemiol. 2009;169:554–64.

    Article  PubMed  Google Scholar 

  56. Sighoko D, Hunt BR, Irizarry B, Watson K, Ansell D, Murphey AM. Disparity in breast cancer mortality by age and geography in 10 racially diverse US cities. Cancer Epidemiol. 2018;53:178–83.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Singh GK, Williams SD, Siahpush M, Mulhollen A. Socioeconomic, rural-urban, and racial inequalities in US cancer mortality: part 1—all cancers and lung cancer and part II—colorectal, prostate, breast, and cervical cancers. J Cancer Epidemiol. 2011:1–27. https://doi.org/10.1155/2011/107497.

    Article  Google Scholar 

  58. Smith GL, Xu Y, Shih YT, et al. Breast-conserving surgery in older patients with invasive breast cancer: current patterns of treatment across the United States. J Am Coll Surg. 2009;209:425–33.

    Article  PubMed  Google Scholar 

  59. Srinivasan S, Moser RP, Willis G, Riley W, Alexander M, Berrigan D, Kobrin S. Small is essential: importance of subpopulation research in cancer control. Am J Public Health. 2015;3:S371–3.

    Article  Google Scholar 

  60. Tarlov E, Zenk SN, Campbell RT, Warnecke RB, Block R. Characteristics of mammography facility locations and stage of breast cancer at diagnosis in Chicago. J Urban Health. 2009;86(2):196–213.

    Article  PubMed  Google Scholar 

  61. Tatalovich Z, Zhu L, Rolin A, et al. Geographic disparities in late stage breast cancer incidence: results from eight states in the United States. Int J Health Geogr. 2015;14:31. https://doi.org/10.1186/s12942-015-0025-5.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Waldorf B, Kim A. Defining and measuring rurality in the U.S.: from typologies to continuous indices. Commissioned paper for the workshop on commissioned paper. Washington, DC: National Academies of Sciences Workshop on Rationalizing Rural Classifications; 2015.. http://sites.nationalacademies.org/cs/groups/dbassesite/documents/webpage/dbasse_168031.pdf

    Google Scholar 

  63. Wang F, McLafferty S, Escamilla V, Luo L. Late-stage breast cancer diagnosis and health care access in Illinois. Prof Geogr. 2008;60(1):54–69.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Welch HG, Passow HJ. Quantifying the benefits and harms of screening mammography. JAMA Intern Med. 2014;174(3):448–54. https://doi.org/10.1001/jamainternmed.2013.13635.

    Article  PubMed  Google Scholar 

  65. Wu S, Powers S, Zhu W, et al. Substantial contribution of extrinsic risk factors to cancer development. Nature. 2016;529:43–7. https://doi.org/10.1038/nature16166.

    Article  CAS  PubMed  Google Scholar 

  66. Yasaitis LC, Arcaya MC, Subramanian SV. Comparison of estimation methods for creating small area rates of acute myocardial infarction among medicare beneficiaries in California. Health Place. 2015;35:95–104.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Yin Y, Wimberley MC. Geographic variations of colorectal and breast cancer late-stage diagnosis and the effects of neighborhood-level factors. J Rural Health. 2017;33:146–57.

    Article  Google Scholar 

  68. Yu XQ, Luo Q, Kahn C, et al. Temporal trends show improved breast cancer survival in Australia but widening urban-rural differences. Breast. 2015;24:524–7.

    Article  PubMed  Google Scholar 

  69. Zahnd WE, Fogleman AJ, Jenkins WD. Rural-urban disparities in stage of diagnosis among cancers with preventive opportunities. Am J Prev Med. 2018;54:688–98.

    Article  PubMed  Google Scholar 

  70. Zahnd W, McLafferty S. Contextual effects and cancer outcomes in the United States: a systematic review of characteristics in multilevel analyses. Ann Epidemiol. 2017;27:739–48.. e3.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Geography and GIScience, University of Illinois at Urbana-Champaign, Champaign, IL, USA

    Sara McLafferty

Authors
  1. Sara McLafferty
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sara McLafferty .

Editor information

Editors and Affiliations

  1. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA

    David Berrigan

  2. Center for Science, Health and Society Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA

    Nathan A. Berger

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

McLafferty, S. (2019). Rural-Urban Disparities in Breast Cancer: Six Suppositions and Future Directions. 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_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-18408-7_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-18407-0

  • Online ISBN: 978-3-030-18408-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation