Geographical and seasonal barriers to mammography services and breast cancer stage at diagnosis

Onitilo, A. A., Liang, H., Stankowski, R. V., Engel, J. M., Broton, M., Doi, S. A. and Miskowiak, D. A. (2014) Geographical and seasonal barriers to mammography services and breast cancer stage at diagnosis. Rural and Remote Health, 14 3: 2738.1-2738.12.

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Author Onitilo, A. A.
Liang, H.
Stankowski, R. V.
Engel, J. M.
Broton, M.
Doi, S. A.
Miskowiak, D. A.
Title Geographical and seasonal barriers to mammography services and breast cancer stage at diagnosis
Journal name Rural and Remote Health   Check publisher's open access policy
ISSN 1445-6354
Publication date 2014-07-01
Sub-type Article (original research)
Open Access Status File (Author Post-print)
Volume 14
Issue 3
Start page 2738.1
End page 2738.12
Total pages 12
Place of publication Deakin West, ACT, Australia
Publisher Australian Rural Health Education Network
Language eng
Formatted abstract
Introduction: Routine mammography screening and early detection are important prognostic indicators for breast cancer. Geographical and seasonal barriers to mammography services and relationship to breast cancer stage at diagnosis were examined.

Methods: Travel time to mammography center, seasonal distribution of mammogram use, mammography frequency, and stage of cancer were retrospectively examined in 1428 female patients diagnosed with primary breast cancer at a tertiary care clinic system in Wisconsin, USA, from 2002 to 2008.

Results: Women with no missed mammograms before diagnosis lived a median of 15 minutes from the nearest facility, while those who missed five of their past five annual mammograms lived nearly twice as far, with a median travel time of 27 minutes (p<0.0001). There was a direct relationship between travel time to nearest mammogram facility and stage of breast cancer at diagnosis, with travel time increasing from 17 to 24 minutes for stage 0 and stage 4 breast cancers, respectively (p=0.0586). Women were less likely to undergo mammography screening during the winter months (p<0.0001), especially women with greater than 30 mi (48.3 km) to travel to the nearest mammogram facility (p=0.0448).

Conclusions: In the studied service area, travel time to nearest mammogram center appears inversely related to regular mammography screening and breast cancer stage at diagnosis. Mammograms are less common in the winter, especially in women with further to travel. This is the first study to demonstrate that inclement winter weather may impact on screening behaviors in rural areas and demonstrates the importance of considering climate as part of geographical access to preventative care.
Keyword Breast neoplasms/diagnosis
Breast neoplasms/epidemiology
Early diagnosis
Geographic information systems
United States/epidemiology
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article 2738

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 11 times in Thomson Reuters Web of Science Article | Citations
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Created: Thu, 29 Jan 2015, 21:35:24 EST by Nyree Divitini on behalf of School of Public Health