Spatial Cluster of Female Breast Cancer in Missouri

Stage at cancer diagnosis has a tremendous impact on type of treatment, recovery and survivor. In most cases the earlier the cancer is detected and treated the higher the survival rate for the patient. Various studies have indicated disparities in access to primary care especially access to screening services like mammogram for early detection. Purpose: To examine the role of spatial access to health care services on incidence of female breast cancer in Missouri. Method: Geostatistical analysis was used to compute the proportions of female breast cancer cases in each geographic location diagnosed at early and late stages. The addresses of healthcare providers participating in the breast and cervical cancer program were also geocoded and used to calculate patient travel time from one point of a provider to another. Results: Between 1996-2007 a total of 55,189 breast cancer cases were reported in Missouri. Out of these 38,089 (69%) were diagnosed at early and 17,093 (31%) were late stage. In addition, a large geographic difference exists in proportions of women diagnosed in the state. Eight of the top 10 total incidence cases per county by population were in rural areas. In addition, even though there are 172 screening centers, access to these services are not evenly distributed. A Euclidean analysis also showed that the distance travel to health care providers for services vary from 9.1 miles to77.2 miles. Conclusion: Women living in areas with limited access to health care services are more likely to be diagnosed with late stage breast cancer.