Journal article
Effect of rurality and travel distance on contralateral prophylactic mastectomy for unilateral breast cancer
Cancer causes & control, Vol.34(S1), pp.171-186
12/2023
DOI: 10.1007/s10552-023-01689-9
PMCID: PMC10689552
PMID: 37095280
Abstract
Despite lack of survival benefit, demand for contralateral prophylactic mastectomy (CPM) to treat unilateral breast cancer remains high. High uptake of CPM has been demonstrated in Midwestern rural women. Greater travel distance for surgical treatment is associated with CPM. Our objective was to examine the relationship between rurality and travel distance to surgery with CPM.
Women diagnosed with stages I-III unilateral breast cancer between 2007 and 2017 were identified using the National Cancer Database. Logistic regression was used to model likelihood of CPM based on rurality, proximity to metropolitan centers, and travel distance. A multinomial logistic regression model compared factors associated with CPM with reconstruction versus other surgical options.
Both rurality (OR 1.10, 95% CI 1.06-1.15 for non-metro/rural vs. metro) and travel distance (OR 1.37, 95% CI 1.33-1.41 for those who traveled 50 + miles vs. < 30 miles) were independently associated with CPM. For women who traveled 30 + miles, odds of receiving CPM were highest for non-metro/rural women (OR 1.33 for 30-49 miles, OR 1.57 for 50 + miles; reference: metro women traveling < 30 miles). Non-metro/rural women who received reconstruction were more likely to undergo CPM regardless of travel distance (ORs 1.11-1.21). Both metro and metro-adjacent women who received reconstruction were more likely to undergo CPM only if they traveled 30 + miles (ORs 1.24-1.30).
The impact of travel distance on likelihood of CPM varies by patient rurality and receipt of reconstruction. Further research is needed to understand how patient residence, travel burden, and geographic access to comprehensive cancer care services, including reconstruction, influence patient decisions regarding surgery.
Details
- Title: Subtitle
- Effect of rurality and travel distance on contralateral prophylactic mastectomy for unilateral breast cancer
- Creators
- Madison M Wahlen - University of IowaIngrid M Lizarraga - University of Iowa Hospitals and ClinicsAmanda R Kahl - Iowa Cancer Registry, Iowa City, IA, USA.Whitney E Zahnd - University of IowaJan M Eberth - Drexel UniversityLinda Overholser - University of Colorado DenverNatoshia Askelson - University of IowaRachel Hirschey - University of North Carolina at Chapel HillKatherine Yeager - Emory UniversitySarah Nash - University of IowaJacklyn M Engelbart - University of Iowa Hospitals and ClinicsMary E Charlton - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Cancer causes & control, Vol.34(S1), pp.171-186
- DOI
- 10.1007/s10552-023-01689-9
- PMID
- 37095280
- PMCID
- PMC10689552
- NLM abbreviation
- Cancer Causes Control
- ISSN
- 0957-5243
- eISSN
- 1573-7225
- Grant note
- U48DP006399 / ACL HHS NIMHD K23 MD015719-01 / NIMHD NIH HHS U48 DP006389 / NCCDPHP CDC HHS U48 DP006377 / NCCDPHP CDC HHS HHSN261201800012I/HHSN26100001 / NCI NIH HHS U48DP006401 / ACL HHS U48 DP006400 / NCCDPHP CDC HHS NIH T32 CA148062 / NIH HHS
- Language
- English
- Electronic publication date
- 04/25/2023
- Date published
- 12/2023
- Academic Unit
- Health Management and Policy; Epidemiology; Surgery; Center for Social Science Innovation; Injury Prevention Research Center; Public Policy Center (Archive); Community and Behavioral Health
- Record Identifier
- 9984399500402771
Metrics
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