Lack of local care leading Appalachian women to be diagnosed with late-stage breast cancer, study says

A lack of qualified local primary care providers—not longer driving distances to see a doctor—is leading Appalachian women to be "diagnosed with late-stage cancer—rather than having it caught early, when it is more easily treatable," says a study by the University of Virginia School of Medicine published in the journal Medical Care. The study, which looked at more than 15,000 women diagnosed with breast cancer from 2006 to 2008 in Kentucky, North Carolina, Ohio and Pennsylvania, found that "21 percent of the women diagnosed with breast cancer had a late-stage diagnosis of breast cancer."

Researchers evaluated three measures of care access: the ratio of care providers to the population, the distances patients must travel to see a provider and the new demographic method, known as the 2SFCA method. Rajesh Balkrishnan, PhD, of the UVA Department of Public Health Sciences, said, “Traditionally when looking at disparities, people have looked at distances—distances to hospitals, distances to physicians, the travel time between the patients and providers. One of the problems is that this doesn’t account for the supply-and-demand factors, which are particularly important in areas of geographic disparity, such as Appalachia.”

Researchers found that "the 2SFCA method, which factors in a host of variables, was the best predictor of the methods assessed," states UVA. Balkrishnan said, “The traditional methods, like distance to physicians, may not give you an accurate indicator of how much of a barrier patients actually face.” (Read more)