Rural health cancer care: A literature review.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18500-e18500
Author(s):  
Wade T. Swenson ◽  
Emily Westergard ◽  
Abigail Paige Swenson
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Rural Health ◽  
Rural Population ◽  
Cancer Care ◽  
Care Delivery ◽  
The United States ◽  
Colorectal Cancers ◽  
Major Topic ◽  
Mesh Terms

e18500 Background: A recent review of the medical literature of rural health cancer care delivery has not been published. We conducted a preliminary review of the last twenty years of rural health cancer care delivery literature utilizing medical subject headings (MeSH) within the PubMed NCBI) database. Methods: Using PubMed MeSH Major Topic terms “rural population” and “cancer” we identified publications published from 2000 to 2020. We searched PubMed for publications that included the major topic MeSH terms “rural population” and “cancer”. We individually reviewed articles, confirmed the focus of the article, and subcategorized the articles. Results: We identified 580 publications which met the search criteria, the majority were focused on the United States (266), followed by China (56), Australia (54), and India (27). Among the publications focusing on the United States, 76 involved Appalachian States. Kentucky (18) and Georgia (10) were the states most frequently represented. Malignancies most commonly represented were: breast cancer (148), uterine/cervical (84), and colorectal cancers (68). The journals which published the most rural health cancer care delivery were The Journal of Rural Health (42), Asian Pacific Journal of Cancer Prevention (20), Cancer (14), Rural and Remote Health (13), Journal of Cancer Education (13), Australian Journal of Rural Health (12). Conclusions: The rural health cancer care literature in the last two decades focuses primarily on the United States, China, Australia, and India. Within the United States, the research focus is Appalachia. The majority of articles focus on breast cancer, uterine/cervical, and colorectal cancers. The journal which published the majority of rural health cancer care articles was the Journal of Rural Health.

scholarly journals Evaluation of the Quality of Adjuvant Endocrine Therapy Delivery for Breast Cancer Care in the United States

JAMA Oncology ◽  
2017 ◽  
Vol 3 (7) ◽  
pp. 928 ◽  
Author(s):  
Bobby Daly ◽  
Olufunmilayo I. Olopade ◽  
Ningqi Hou ◽  
Katharine Yao ◽  
David J. Winchester ◽  
...  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Endocrine Therapy ◽  
Cancer Care ◽  
The United States ◽  
Adjuvant Endocrine Therapy ◽  
Breast Cancer Care ◽  
Therapy Delivery

Issues in Breast Cancer Survivorship: Optimal Care, Bone Health, and Lifestyle Modifications

2016 ◽  
pp. e22-e29
Author(s):  
Michelle E. Melisko ◽  
William J. Gradishar ◽  
Beverly Moy
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Bone Health ◽  
Breast Cancer Survivors ◽  
Care Delivery ◽  
Large Population ◽  
The United States ◽  
Breast Cancers ◽  
Lifestyle Modifications ◽  
Increased Risk

There are an estimated 3.1 million survivors of breast cancer in the United States. The predominant reasons for this substantially large population are that breast cancer is the most common noncutaneous malignancy among women and that 5-year survival rates after breast cancer treatment are approximately 90%. These patients have many medical considerations, including the need to monitor for disease recurrence and to manage complications of their previous cancer treatments. Most patients remain at risk indefinitely for local and systemic recurrences of their breast cancers and have an increased risk of developing contralateral new primary breast cancers. Therefore, optimizing care for this patient population is critical to the overall health care landscape in the United States. Here, we summarize survivorship care delivery and its challenges, the optimization of bone health in breast cancer survivors, and opportunities for risk reduction through lifestyle modifications.

scholarly journals Breast cancer care in the Canada and the United States: Ecological comparisons of extremely impoverished and affluent urban neighborhoods

2010 ◽  
Vol 16 (1) ◽  
pp. 156-163 ◽  
Author(s):  
Kevin M. Gorey ◽  
Isaac N. Luginaah ◽  
Caroline Hamm ◽  
Karen Y. Fung ◽  
Eric J. Holowaty
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Cancer Care ◽  
The United States ◽  
Urban Neighborhoods ◽  
Breast Cancer Care

scholarly journals Delays in breast cancer care by race and sexual orientation: Results from a national survey with diverse women in the United States

Cancer ◽  
2021 ◽  
Author(s):  
Tonia C. Poteat ◽  
Mary Anne Adams ◽  
Jowanna Malone ◽  
Sophia Geffen ◽  
Naomi Greene ◽  
...  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Sexual Orientation ◽  
National Survey ◽  
Cancer Care ◽  
The United States ◽  
Breast Cancer Care

scholarly journals Equity-Driven Approaches to Optimizing Cancer Care Coordination and Reducing Care Delivery Disparities in Underserved Patient Populations in the United States

2021 ◽  
Vol 17 (5) ◽  
pp. 215-218
Author(s):  
Randall A. Oyer ◽  
Matthew P. Smeltzer ◽  
Amanda Kramar ◽  
Leigh M. Boehmer ◽  
Christopher S. Lathan
Keyword(s):  
United States ◽  
Care Coordination ◽  
Cancer Care ◽  
Care Delivery ◽  
The United States

Effect of shorter time to treatment on survival in rural patients with breast cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7027-7027
Author(s):  
Suneel Deepak Kamath ◽  
Wei Wei ◽  
Katherine Tullio ◽  
Gregory S. Cooper ◽  
Alok A. Khorana
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Socioeconomic Factors ◽  
Cancer Care ◽  
The United States ◽  
Disease Stage ◽  
Cancer Center ◽  
Median Income ◽  
Cox Models ◽  
Rural Patients

7027 Background: Rural cancer care in the United States has unique challenges from variable access to care. This study examined differences in time to first treatment (TTT), a potential surrogate for access, and predictors of overall survival (OS) between rural and non-rural patients with breast cancer. Methods: Women with stage I-III breast cancer from 2004-2012 in the National Cancer Database of Commission on Cancer (CoC)-accredited facilities were included and categorized as rural and non-rural. Differences in demographic, disease and treatment characteristics, socioeconomic factors and TTT (< 4 weeks, 4-8 weeks and > 8 weeks) between rural and non-rural patients were assessed by Chi-square test. The effect of age, insurance status, cancer center type, community median income, community % no high school, and TTT on OS were assessed using univariate and multivariate Cox models. Results: The study included 1,205,031 patients, 18,417 (2%) of whom were rural. Compared to non-rural patients, rural patients were more likely to be age > 65, Caucasian, receive care at non-academic centers, have government insurance, have lower income and less education (p < 0.0001 for all). Significant demographic and socioeconomic differences are shown in Table. Rural patients had shorter mean TTT (3.72 vs. 4.35 weeks, p < 0.0001). More rural patients had TTT < 4 weeks (67% vs. 57%) and < 8 weeks (94% vs. 90%), p < 0.0001 for both. Shorter TTT (both < 4 weeks vs. 8 weeks and 4-8 weeks vs. > 8 weeks) was associated with improved OS (HR: 0.84, 95% CI: 0.82-0.86, p < 0.0001 and HR: 0.82, 95% CI: 0.81-0.83, p < 0.0001, respectively). After adjusting for demographic, socioeconomic, disease stage and treatment factors, rural status was associated with significantly better OS compared to non-rural status (HR: 0.92, 95% CI: 0.89-0.96, p < 0.0001). Conclusions: Despite several adverse socioeconomic factors, rural patients with breast cancer with access to CoC-accredited facilities had significantly shorter TTT and better OS compared to non-rural patients. These data suggest improving TTT can mitigate disparities in rural cancer care. It is unclear whether our data apply to non-CoC-accredited facilities in rural United States. [Table: see text]

The Urban/Rural Dichotomy in the Distribution of Breast Cancer across Pennsylvania

2015 ◽  
Vol 81 (9) ◽  
pp. 884-888 ◽  
Author(s):  
Stefanos Boukovalas ◽  
Jack Sariego
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Population Density ◽  
Rural Areas ◽  
Rural Population ◽  
Death Rate ◽  
The United States ◽  
Rural Counties ◽  
Surveillance Programs ◽  
Cancer Rates

Breast cancer rates clearly differ across the United States. This is due to a variety of factors, but at least one determinant is the population density. Breast cancer detection rates and treatment paradigms may differ in rural areas when compared with more urban ones. As the population becomes more mobile and diffuse, this may or may not be a worsening problem. The current analysis was undertaken to examine the breast cancer incidence and outcomes in a single state in an attempt to plan for resource allocation in the future. A retrospective analysis was performed using data available from the Pennsylvania Department of Health regarding breast cancer rates by county, the distribution of cases with regard to degree of rurality, death rates by county as a function of rurality, and the age distribution of all presenting cases. Data from 1999 were compared with those of 2009. The United States Census Bureau definition of rurality was used, which specifies that a county be classified as rural if the population density is less than 284 persons/square mile. Between 1999 and 2009, the population of Pennsylvania increased by approximately 3.4 per cent (421,325 people). The urban population increased by 3.9 per cent, whereas the rural population increased by only 2.2 per cent. During that same period, the number of cancer cases/100,000 population remained about the same: 391.41 in 1999; 390.7 in 2009. However, the distribution of cases shifted during that time toward more rural areas of the state: in 1999, there were 372.3 breast cancer cases/100,000 population compared with 2009 when the rate was 384.4/100,000 population. The number of cancer deaths/100,000 population actually dropped overall during the decade: 98.5 in 1999 versus 82.3 in 2009. Though this was true in both urban and rural counties, the decrease was much less pronounced in the rural areas. In urban counties, the death rate dropped from 100.5 to 81.5/100,000 population, whereas in rural counties, the drop was only from 93.3 to 84.3. The greater increase in cases diagnosed in rural areas of Pennsylvania is only partially explained by the relatively greater increase in rural population. There are undoubtedly other issues at work in rural areas: environmental factors, diffusion of resources, less access to surveillance programs. In addition, though the death rate has dropped in both rural and urban areas, this is much less pronounced in rural counties. Coupled with the increase in prevalence in those areas, this suggests that breast cancer care may be lagging in rural areas. There is a need to examine allocation of resources and surveillance programs.

Results of the National Initiative for Cancer Care Quality: How Can We Improve the Quality of Cancer Care in the United States?

2006 ◽  
Vol 24 (4) ◽  
pp. 626-634 ◽  
Author(s):  
Jennifer L. Malin ◽  
Eric C. Schneider ◽  
Arnold M. Epstein ◽  
John Adams ◽  
Ezekiel J. Emanuel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
United States ◽  
Cancer Care ◽  
Medical Records ◽  
Significant Variation ◽  
Quality Measures ◽  
The United States ◽  
Recommended Care

Purpose In 1999, the National Cancer Policy Board called attention to the quality of cancer care in the United States and recommended establishing a quality monitoring system with the capability of regularly reporting on the quality of care for patients with cancer. Methods Using data from a patient survey 4 years after diagnosis and review of medical records, we determined the percentage of stage I to III breast cancer and stage II to III colorectal cancer survivors in five metropolitan statistical areas (MSAs) across the United States who received recommended care specified by a comprehensive set of explicit quality measures. Results Two thousand three hundred sixty-six (63%) of 3,775 eligible patients responded to the survey, and 85% consented to have their medical records reviewed. Our final analytic sample (n = 1,765) included 47% of the eligible patients. Patients with breast and colorectal cancer received 86% of recommended care (95% CI, 86% to 87%) and 78% of recommended care (95% CI, 77% to 79%), respectively. Adherence to quality measures was less than 85% for 18 of the 36 breast cancer measures, and significant variation across MSAs was observed for seven quality measures. The percent adherence was less than 85% for 14 of the 25 colorectal cancer measures, and one quality measure demonstrated statistically significant variation across the MSAs. Conclusion Initial management of patients with breast and colorectal cancer in the United States seemed consistent with evidence-based practice; however, substantial variation in adherence to some quality measures point to significant opportunities for improvement.

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