Disparities Contributing to Late-Stage Diagnosis of Lung, Colorectal, Breast, and Cervical Cancers: Rural and Urban Poverty in Florida

Author:

Hall Jaclyn M.12,Mkuu Rahma S.1,Cho Hee Deok12,Woodard Jennifer N.13,Kaye Frederic J.4,Bian Jiang12ORCID,Shenkman Elizabeth A.1ORCID,Guo Yi12ORCID

Affiliation:

1. Department of Health Outcomes and Biomedical Informatics, University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA

2. Cancer Informatics Shared Resource, University of Florida Health Cancer Center, 2033 Mowry Road, Gainesville, FL 32610, USA

3. Community Outreach and Engagement, University of Florida Health Cancer Center, 2033 Mowry Road, Gainesville, FL 32610, USA

4. Division of Hematology and Oncology, Department of Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, USA

Abstract

Despite advances in cancer screening, late-stage cancer diagnosis is still a major cause of morbidity and mortality in the United States. In this study, we aim to understand demographic and geographic factors associated with receiving a late-stage diagnosis (LSD) of lung, colorectal, breast, or cervical cancer. (1) Methods: We analyzed data of patients with a cancer diagnosis between 2016 and 2020 from the Florida Cancer Data System (FCDS), a statewide population-based registry. To investigate correlates of LSD, we estimated multi-variable logistic regression models for each cancer while controlling for age, sex, race, insurance, and census tract rurality and poverty. (2) Results: Patients from high-poverty rural areas had higher odds for LSD of lung (OR = 1.23, 95% CI (1.10, 1.37)) and breast cancer (OR = 1.31, 95% CI (1.17,1.47)) than patients from low-poverty urban areas. Patients in high-poverty urban areas saw higher odds of LSD for lung (OR = 1.05 95% CI (1.00, 1.09)), breast (OR = 1.10, 95% CI (1.06, 1.14)), and cervical cancer (OR = 1.19, 95% CI (1.03, 1.37)). (3) Conclusions: Financial barriers contributing to decreased access to care likely drive LSD for cancer in rural and urban communities of Florida.

Funder

the National Institute on Aging

the National Cancer Institute

Centers for Disease Control and Prevention

Publisher

MDPI AG

Subject

Cancer Research,Oncology

Reference66 articles.

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3. (2023, February 01). Leading Health Indicators—Healthy People 2030|health.gov, Available online: https://health.gov/healthypeople/objectives-and-data/leading-health-indicators.

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