Identifying key barriers to effective breast cancer control in rural settings
Open accessAbstract
Breast cancer is the most common cancer and the second most common cause of cancer mortality among women in the United States. Efforts to promote breast cancer control in rural settings face specific challenges. Access to breast cancer screening, diagnosis, and treatment services is impaired by shortages of primary care and specialist providers, and geographic distance from medical facilities. Women in rural areas have comparable breast cancer mortality rates compared to women in urban settings, but this is due in large part to lower incidence rates and masks a substantial rural/urban disparity in breast cancer survival among women diagnosed with breast cancer. Mammography screening utilization rates are slightly lower among rural women than their urban counterparts, with a corresponding increase in late stage breast cancer. Differences in breast cancer survival persist after controlling for stage at diagnosis, largely due to disparities in access to treatment. Travel distance to treatment centers is the most substantial barrier to improved breast cancer outcomes in rural areas. While numerous interventions have been demonstrated in controlled studies to be effective in promoting treatment access and adherence, widespread dissemination in public health and clinical practice remains lacking. Efforts to improve breast cancer control in rural areas should focus on implementation strategies for improving access to breast cancer treatments.
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Lack of equitable access to diagnosis and treatment is prominent in diseases ranging from breast cancer, depression, to diabetic eye disease.
“While there are multiple reasons for avoidable health inequities2, lack of equitable access to diagnosis and treatment are prominent in diseases ranging from breast cancer, depression, to diabetic eye disease3–8.”
From Considerations for addressing bias in artificial intelligence for health equity (2023) · cites this paper as [4]
Healthcare AI systems have the potential to foster access to healthcare for underserved populations, while improving care quality at both the individual patient and population levels, at reduced cost for patients, payors, and society.
“Healthcare AI systems have the potential to foster access to healthcare for underserved populations, while improving care quality at both the level of the individual patient and the population, at reduced cost for patients, payors, and society2–8,10,12–16.”
From Considerations for addressing bias in artificial intelligence for health equity (2023) · cites this paper as [4]
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- Authors
- Sprague, B. L., Ahern, T. P., Herschorn, S. D., Sowden, M., Weaver, D. L., & Wood, M. E.
- Affiliations
- University of Vermont (US)
- Corresponding author
- Sprague, Brian L.
- ORCID
- Venue
- Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2021-11
- Volume
- 152
- Issue
- Pt 2
- Pages
- 106741
- ISSN
- 0091-7435 (ISSN-L)
- PMC
- PMC8545865
- OpenAlex
- W3184088106
- Cited by
- 70
- References
- 83
- Citations by year
- 2026: 20 · 2025: 24 · 2024: 9 · 2023: 11 · 2022: 5 · 2021: 1
- FWCI
- 2.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute
- National Institute of General Medical Sciences
- Topics
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Digital Radiography and Breast Imaging
- Keywords
- breast cancer, rural health, breast cancer control, health care access, mammography screening, urban-rural differences, breast cancer survival, late-stage breast cancer, health workforce shortage, implementation strategies
- MeSH terms
- Breast Neoplasms, Female, Health Services Accessibility, Humans, Mammography, Rural Population, United States, Urban Population, Early Detection of Cancer
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