scholarly journals Assessing health disparities in breast cancer incidence burden in Tennessee: geospatial analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bonita Salmeron ◽  
Lohuwa Mamudu ◽  
Xiaohui Liu ◽  
Martin Whiteside ◽  
Faustine Williams

Abstract Background Tennessee women experience the 12th highest breast cancer mortality in the United States. We examined the geographic differences in breast cancer incidence in Tennessee between Appalachian and non-Appalachian counties from 2005 to 2015. Methods We used ArcGIS 10.7 geospatial analysis and logistic regression on the Tennessee Cancer Registry incidence data for adult women aged ≥ 18 years (N = 59,287) who were diagnosed with breast cancer from 2005 to 2015 to evaluate distribution patterns by Appalachian county designation. The Tennessee Cancer Registry is a population-based, central cancer registry serving the citizens of Tennessee and was established by Tennessee law to collect and monitor cancer incidence. The main outcome was breast cancer stage at diagnosis. Independent variables were age, race, marital status, type of health insurance, and county of residence. Results Majority of the sample were White (85.5%), married (58.6%), aged ≥ 70 (31.3%) and diagnosed with an early stage breast cancer (69.6%). More than half of the women had public health insurance (54.2%), followed by private health insurance coverage (44.4%). Over half of the women resided in non-Appalachian counties, whereas 47.6% were in the Appalachian counties. We observed a significant association among breast cancer patients with respect to marital status and type of health insurance coverage (p =  < 0.0001). While the logistic regression did not show a significant result between county of residence and breast cancer incidence, the spatial analysis revealed geographic differences between Appalachian and non-Appalachian counties. The highest incidence rates of 997.49–1164.59/100,000 were reported in 6 Appalachian counties (Anderson, Blount, Knox, Rhea, Roane, and Van Buren) compared to 3 non-Appalachian counties (Fayette, Marshall, and Williamson). Conclusions There is a need to expand resources in Appalachian Tennessee to enhance breast cancer screening and early detection. Using geospatial techniques can further elucidate disparities that may be overlooked in conventional linear analyses to improve women’s cancer health and associated outcomes.

Author(s):  
Rini Mayasari Rini Mayasari

ABSTRACT Breast cancer on the mark with the growth or uncontrolled growth of cells that are excessive. Factors affecting the incidence of breast cancer include maternal age, marital status, family history, hormone use, radiation, manarche, and obesity. The purpose of this study was to determine the relationship between Age and Marital Status of Mother with Breast Cancer incidence in the Installation Surgeon General Hospital Dr. Mohammad Hoesin Palembang in 2012. The study design was analytical descriptive with the approach in which the independent variables Cross Sectional Age Mother and Status Perkawianan and dependent variables in breast cancer incidence collected at the same time. The study population was all women who develop breast cancer in the Installation General Hospital Surgery Center Dr. Mohammad Hoesin Palembang in 2012 and samples taken by systematic random sampling with a sample of 130 respondents. The results of univariate analysis of data showed that respondents had breast cancer with a percentage of total 58 (44.61%) while respondents who had not had breast cancer totaled 72 by the percentage (63.39%). Respondents by Age Mothers who are at risk amounted to 34 by the percentage (26.15%) while respondents with Age Mothers who are not at risk amounted to 96 by the percentage (73.85%). Respondents by Marital Status is married and the mother who totaled 69 by the percentage (53.07%) and Marital Status with the status of unmarried women totaled 61 by the percentage (46.03%). Of Chi-Square test results found no significant relationship between Age Mothers with Breast Cancer event in which the p value = 0.007, no significant relationship between Marital Status in Breast Cancer event in which the p value = 0.030. Based on the results of the study, researchers suggest counseling efforts, medical knowledge and improve the quality of health services in order to reduce the incidence of breast cancer..   ABSTRAK Kanker payudara di tandai dengan pertumbuhan atau perkembangan tidak terkontrol dari sel-sel yang berlebihan. Faktor-faktor yang mempengaruhi kejadian kanker payudara antara lain umur ibu, status perkawinan, riwayat keluarga, penggunaan hormon, radiasi, manarche, dan obesitas. Tujuan penelitian ini adalah untuk mengetahui hubungan antara Umur Ibu dan Status Perkawinan dengan kejadian Kanker Payudara di Instalasi Bedah Rumah Sakit Umum Pusat Dr. Mohammad Hoesin Palembang Tahun 2012. Desain Penelitian ini adalah deskriptif analitik dengan pendekatan Cross Sectional dimana variabel independen Umur Ibu dan Status Perkawianan dan variabel dependen kejadian kanker payudara dikumpulkan dalam waktu yang bersamaan. Populasi penelitian ini adalah semua ibu yang menderita kanker payudara di Instalasi Bedah Rumah Sakit Umum Pusat Dr. Mohammad Hoesin Palembang Tahun 2012 dan sampel di ambil secara systematic random sampling dengan jumlah sampel 130 responden. Hasil analisis univariat data menunjukan responden yang mengalami Kanker Payudara berjumlah 58 dengan persentase sebesar (44,61%) sedangkan responden yang tidak mengalami Kanker Payudara berjumlah 72 dengan persentase (63,39%). Responden dengan Umur Ibu yang beresiko berjumlah 34 dengan persentase (26,15%) sedangkan responden dengan Umur Ibu yang tidak beresiko berjumlah 96 dengan persentase (73,85%). Responden dengan Status Perkawinan ibu yang berstatus kawin berjumlah 69 dengan persentase (53,07%) dan Status Perkawinan ibu yang berstatus tidak kawin berjumlah 61 dengan persentase (46,03%). Dari hasil uji Chi-Square didapatkan ada hubungan bermakna antara Umur Ibu dengan kejadian Kanker Payudara dimana p Value = 0,007, ada hubungan bermakna antara Status Perkawinan dengan kejadian Kanker Payudara dimana p Value = 0,030. Berdasarkan hasil penelitian, peneliti menyarankan upaya-upaya penyuluhan, pengetahuan tenaga medis dan meningkatkan mutu pelayanan kesehatan guna menurunkan angka kejadian kanker payudara.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255354
Author(s):  
Taiwo A. Obembe ◽  
Jonathan Levin ◽  
Sharon Fonn

Background Out of Pocket (OOP) payment continues to persist as the major mode of payment for healthcare in Nigeria despite the introduction of the National Health Insurance Scheme (NHIS). Although the burden of health expenditure has been examined in some populations, the impact of OOP among slum dwellers in Nigeria when undergoing emergencies, is under-researched. This study sought to examine the prevalence, factors and predictors of catastrophic health expenditure amongst selected slum and non-slum communities undergoing emergency surgery in Southwestern Nigeria. Methods The study utilised a descriptive cross-sectional survey design to recruit 450 households through a multistage sampling technique. Data were collected using pre-tested semi-structured questionnaires in 2017. Factors considered for analysis relating to the payer were age, sex, relationship of payer to patient, educational status, marital status, ethnicity, occupation, income and health insurance coverage. Variables factored into analysis for the patient were indication for surgery, grade of hospital, and type of hospital. Households were classified as incurring catastrophic health expenditure (CHE), if their OOP expenditure exceeded 5% of payers’ household budget. Analysis of the data took into account the multistage sampling design. Results Overall, 65.6% (95% CI: 55.6–74.5) of the total population that were admitted for emergency surgery, experienced catastrophic expenditure. The prevalence of catastrophic expenditure at 5% threshold, among the population scheduled for emergency surgeries, was significantly higher for slum dwellers (74.1%) than for non-slum dwellers (47.7%) (F = 8.59; p = 0.019). Multiple logistic regression models revealed the significant independent factors of catastrophic expenditure at the 5% CHE threshold to include setting of the payer (whether slum or non-slum dweller) (p = 0.019), and health insurance coverage of the payer (p = 0.012). Other variables were nonetheless significant in the bivariate analysis were age of the payer (p = 0.017), income (p<0.001) and marital status of the payer (p = 0.022). Conclusion Although catastrophic health expenditure was higher among the slum dwellers, substantial proportions of respondents incurred catastrophic health expenditure irrespective of whether they were slum or non-slum dwellers. Concerted efforts are required to implement protective measures against catastrophic health expenditure in Nigeria that also cater to slum dwellers.


1993 ◽  
Vol 329 (5) ◽  
pp. 326-331 ◽  
Author(s):  
John Z. Ayanian ◽  
Betsy A. Kohler ◽  
Toshi Abe ◽  
Arnold M. Epstein

Author(s):  
Razieh Bidhendi-Yarandi ◽  
Mohammad Hossein Panahi

Background: Cancer is one of the most important causes of death in the world and has an increasing trend globally. We aimed at investigating the five leading cancers in Iranian women based on a 10-year history of cancer registry reports and illustrating the trends in all cancer sites and breast cancer as the top leading one from 2003 to 2015. Methods: Data were obtained from national cancer registry study. Age-Specific Incidence Rate (ASR) data were obtained from Iran’s annual national cancer registry reports between 2003 to 2010 and 2014 to 2015. Using Joinpoint regression, we analyzed incidence trends over time for all cancer sites and the top leading cancer from 2003 to 2015. Results: Breast cancer was ranked first in Iranian women. Its ASR raised from 15.96 in 2003 to 32.63 in 2015. Results of trend analysis based on Annual Percent Change (APC) index showed 5.6 (95%CI: 2.9 to 8.3) and 4.6 (95%CI: 2.0 to 7.2) annual increase in the incidence of all cancer sites and breast cancer from 2003 to 2015, respectively. Conclusion: This study indicates significant increasing trends in all cancer sites and breast cancer incidence in Iran. Despite the national coverage of cancer registry over the past decade, more considerations should be taken into account, especially in Breast cancer.


2019 ◽  
Author(s):  
Ines Mesa-Eguiagaray ◽  
Sarah H Wild ◽  
Philip S. Rosenberg ◽  
Sheila M Bird ◽  
David H Brewster ◽  
...  

AbstractBackgroundStrategies for breast cancer prevention are informed by assessing whether incidence differs by tumour biology. We describe temporal trends of breast cancer incidence by molecular subtypes in Scotland.MethodsPopulation-based cancer registry data on 72,217 women diagnosed with incident primary breast cancer from 1997 to 2016 were analysed. Age-standardised rates (ASR) and age-specific incidence were estimated by tumour subtype after imputing the 8% of missing oestrogen receptor (ER) status. Joinpoint regression and age- period- cohort models were used to assess whether significant differences were observed in incidence trends by ER status.ResultsER positive tumour incidence steadily increased particularly for women of screening age 50 to 69 years from 1997 till around 2011 (1.6%/year, 95%CI: 1.2 to 2.1). ER negative incidence decreased among all ages at a consistent rate of −0.7%/year (95%CI: −1.5, 0) from around 2000-2016. Compared to the 1941-1959 central birth cohort, women born 1912-1940 had lower incidence rate ratios (IRR) for ER+ tumours and women born 1960- 1986 had higher IRR for ER- tumours.ConclusionsWe show evidence of aetiologic heterogeneity of breast cancer. Future incidence and survival reporting should be monitored by molecular subtypes.


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