Researchers at the American Cancer Society (ACS) identified significant disparities in the stage of breast cancer diagnosis across rural regions of the United States. Published online on May 22, 2024, in 'JAMA Network Open', the study analyzed data from 2010-2019, revealing that some rural clusters had late-stage diagnosis rates as high as 36.3% while others were as low as 29.8%. This research utilized county-level data from the North American Association of Central Cancer Registries, encompassing 450,223 breast cancer cases.
The analysis focused on 18 distinct rural regional clusters, covering 70% of the rural US population. Higher rates of late-stage breast cancer diagnoses were concentrated in the South, particularly Appalachia, the Mississippi Delta, and parts of Texas, Oklahoma, and Arkansas, along with a cluster in the Great Plains/Upper Midwest. In contrast, rural clusters in the Northeast, Pacific Northwest, and other parts of the Great Plains exhibited lower late-stage diagnosis rates. These disparities remained significant even after adjusting for socioeconomic factors such as poverty and lack of health insurance, suggesting other contributing elements.
The findings imply that factors beyond economic status and insurance coverage, such as healthcare infrastructure, physician density, and cultural attitudes towards screening, likely contribute to these regional differences. Dr. Alpa V. Patel, senior author and senior vice president of Population Science at the American Cancer Society, stated, 'Our findings highlight the critical need for region-specific policies and targeted interventions.' This underscores the necessity for tailored cancer control strategies to address the unique challenges faced by diverse rural communities in the US.
