Late-Stage Breast Cancer Diagnosis and Health Care Access in Illinois∗

Bibliographic Data

ID5783455
AuthorsFahui Wang (0000-0001-7152-2226, Louisiana State University), Sara Mclafferty, L Mclafferty (0000-0001-8413-7562, University of Illinois Urbana-Champaign), Verónica Escamilla (0000-0002-0857-4338, University of North Carolina at Chapel Hill), Lan Luo (0009-0004-5545-1164, University of Illinois Urbana-Champaign)
Year2008
Volume60
Issue1
Pages54-69
Publication date2008-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueThe Professional Geographer (JOURNAL)
Journal identifiersISSN: 0033-0124 • E-ISSN: 1467-9272
PublisherRoutledge (PUBLISHER • GB)
DOI10.1080/00330120701724087
PMID18458760
PMCIDPMC2367325
OpenAlexW2059299474
LanguageEN
Citations received51
References cited51

The variations of breast cancer mortality rates from place to place reflect both underlying differences in breast cancer prevalence and differences in diagnosis and treatment that affect the risk of death. This article examines the role of access to health care in explaining the variation of late-stage diagnosis of breast cancer. We use cancer registry data for the state of Illinois by zip code to investigate spatial variation in late diagnosis. Geographic information systems and spatial analysis methods are used to create detailed measures of spatial access to health care such as convenience of visiting primary care physicians and travel time from the nearest mammography facility. The effects of spatial access, in combination with the influences of socioeconomic factors, on late-stage breast cancer diagnosis are assessed using statistical methods. The results suggest that for breast cancer, poor geographical access to primary health care significantly increases the risk of late diagnosis for persons living outside the city of Chicago. Disadvantaged population groups including those with low income and racial and ethnic minorities tend to experience high rates of late diagnosis. In Illinois, poor spatial access to primary health care is more strongly associated with late diagnosis than is spatial access to mammography. This suggests the importance of primary care physicians as gatekeepers in early breast cancer detection

Breast cancer screening · Disadvantaged · Data-Driven Disease Surveillance · Health disparities and outcomes · Spatial and Panel Data Analysis