Is availability of mammography services at federally qualified health centers associated with breast cancer mortality-to-incidence ratios? An ecological analysis

제목
Is availability of mammography services at federally qualified health centers associated with breast cancer mortality-to-incidence ratios? An ecological analysis
저자

Swann Arp Adams; Seul Ki Choi; Jan M. Eberth; Daniela B. Friedman; Mei Po Yip; Reginald D. Tucker-Seeley; Lisa T. Wigfall; James R. Hébert

발행연도
2015-11-10
발행기관
Mary Ann Liebert
Series
Journal of Women's Health, vol. 24, no. 11, pp. 916 - 923
Journal Title
Journal of Women's Health
초록
Objective: Mammography is the most effective method to detect breast cancer in its earliest stages, reducing the risk of breast cancer death. We investigated the relationship between accessibility of mammography services at Federally Qualified Health Centers (FQHCs) and mortality-to-incidence ratio (MIR) of breast cancer in each county in the United States.
Methods: County-level breast cancer mortality and incidence rates in 2006–2010 were used to estimate MIRs. We compared breast cancer MIRs based on the density and availability of FQHC delivery sites with or without mammography services both in the county and in the neighboring counties.
Results: The relationship between breast cancer MIRs and access to mammography services at FQHCs differed by race and county of residence. Breast cancer MIRs were lower in counties with mammography facilities or FQHC delivery sites than in counties without a mammography facility or FQHC delivery site. This trend was stronger in urban counties (p=0.01) and among whites (p=0.008). Counties with a high density of mammography facilities had lower breast cancer MIRs than other counties, specifically in urban counties (p=0.01) and among whites (p=0.01). Breast cancer MIR for blacks was the lowest in counties having mammography facilities; and was highest in counties without a mammography facility within the county or the neighboring counties (p=0.03).
Conclusions: Mammography services provided at FQHCs may have a positive impact on breast cancer MIRs. Expansion of services provided at the FQHCs and placement of FQHCs in additional underserved areas might help to reduce cancer disparities in the United States.
ISSN
1540-9996
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