Urban/rural disparities in breast cancer screening and incidence rates: Socioeconomic and healthcare explanations

Authors

• JL Moss
• B Liu

Abstract

Background. Mammography and breast cancer incidence rates are higher in urban than rural areas. Public health efforts have made little progress in explaining or resolving geographic disparities in cancer. This study examined potential mechanisms connecting urbanicity to breast cancer screening and incidence, focusing on socioeconomic status (SES) and the quality of the healthcare system. Methods. Data on 612 counties came from national sources on rural-urban continuum codes, SES quintile, physician density, mammography rates, and breast cancer incidence for 2000-2004. Weighted least squares regressions were conducted, with Sobel tests to evaluate the indirect (mediating) effects of screening, SES, and physician density on the relationship between urbanicity and cancer. Bootstrapped sampling was used to calculate 95% confidence intervals (CIs). Results. Urban counties had higher levels of mammography (p

Scientific Focus Area: Health Disparities

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