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Journal article
A catchment and location-allocation analysis of mammography access in Delaware, US: implications for disparities in geographic access to breast cancer screening
Breast cancer research : BCR, v 25(1), 137
08 Nov 2023
PMID: 37941020
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background
Despite a 40% reduction in breast cancer mortality over the last 30 years, not all groups have benefited equally from these gains. A consistent link between later stage of diagnosis and disparities in breast cancer mortality has been observed by race, socioeconomic status, and rurality. Therefore, ensuring equitable geographic access to screening mammography represents an important priority for reducing breast cancer disparities. Access to breast cancer screening was evaluated in Delaware, a state that experiences an elevated burden from breast cancer but is otherwise representative of the US in terms of race and urban-rural characteristics. We first conducted a catchment analysis of mammography facilities. Finding evidence of disparities by race and rurality, we next conducted a location-allocation analysis to identify candidate locations for the establishment of new mammography facilities to optimize equitable access.
Methods
A catchment analysis using the ArcGIS Pro Service Area analytic tool characterized the geographic distribution of mammography sites and Breast Imaging Centers of Excellence (BICOEs). Poisson regression analyses identified census tract-level correlates of access. Next, the ArcGIS Pro Location-Allocation analytic tool identified candidate locations for the placement of additional mammography sites in Delaware according to several sets of breast cancer screening guidelines.
Results
The catchment analysis showed that for each standard deviation increase in the number of Black women in a census tract, there were 68% (95% CI 38-85%) fewer mammography units and 89% (95% CI 60-98%) fewer BICOEs. The more rural counties in the state accounted for 41% of the population but only 22% of the BICOEs. The results of the location-allocation analysis depended on which set of screening guidelines were adopted, which included increasing mammography sites in communities with a greater proportion of younger Black women and in rural areas.
Conclusions
The results of this study illustrate how catchment and location-allocation analytic tools can be leveraged to guide the equitable selection of new mammography facility locations as part of a larger strategy to close breast cancer disparities.
Metrics
Details
- Title
- A catchment and location-allocation analysis of mammography access in Delaware, US: implications for disparities in geographic access to breast cancer screening
- Creators
- Jessica L. Webster - Drexel Univ, Dornsife Sch Publ Hlth, Dept Epidemiol & Biostat, Philadelphia, PA USANeal D. Goldstein - Drexel University, Epidemiology and BiostatisticsJennifer P. Rowland - Christiana Care Health SystemCatherine M. Tuite - Christiana Care Health SystemScott D. Siegel - Christiana Care Health System
- Publication Details
- Breast cancer research : BCR, v 25(1), 137
- Publisher
- Springer Nature
- Number of pages
- 12
- Grant note
- We would like to acknowledge the HFGCCRI Community Research Advisory Board (CRAB) for consulting with us on the design of our TNBC research projects. This project was supported by NIGMS (P20 GM103446) [UDE] from the NIH and the State of Delaware (to S.D. Siegel).
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:001097372500001
- Scopus ID
- 2-s2.0-85175966660
- Other Identifier
- 991021860734104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology