Factors Influencing Breast Cancer Treatment in Kentucky

Breast cancer is the most common form of cancer among Kentucky women with an incident rate estimated to be 120 cases per 100,000 women. There are two standards of care for early stage breast cancer: mastectomy and breast-conserving surgery (BCS) followed by radiation therapy (RT). Survival rates of women concordant with treatment care were significantly higher than non-concordant women (3). Geographic variation has been found to have an effect on surgery choice and radiation therapy concordance (2-5). Past research has focused on follow-up of BCS with RT, but to date, there has not been any research that focuses on concordance with guidelines for specific breast cancer stage, no matter the stage.

Participants were recruited from The Breast and Prostate Cancer Data Quality and Patterns of Care Study (POC-BP) and included women residents of Kentucky who were 20 years of age or older, and diagnosed in 2004 with primary confirmed breast cancer. Bivariate analyses were performed to examine relationship between treatment strategy concordance and sociodemographic and economic characteristics. Multivariate logistic regression was used to evaluate association between age, location, and treatment adherence. Treatment strategies of discordant women were examined to find which component had the highest percentage of non-compliance. Bivariate analyses were conducted against missing treatment options.

Women with breast cancer living in the Appalachian region of Kentucky are at a 54% less odds of following through on their guideline treatment recommendations. Missing treatment strategies show that components involving distance and regular visits are less likely to have follow through