title: Differences in male breast cancer stage, tumor size at diagnosis, and survival rate between metropolitan and nonmetropolitan regions.
abstract: Although the incidence for breast cancer in men is lower than for women, male breast cancer (MBC) patients are diagnosed at a later stage and have a higher mortality rate than women. This study examined male cases reported from 1988 through 2006 in the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute for differences in cancer stage, tumor size at diagnosis, and survival rate between metropolitan and nonmetropolitan regions. Pearson's chi-square was used to evaluate differences in stage and tumor size at diagnosis. Cox proportional hazards regression was used to assess survival differences after adjusting for confounders (race, marital status, median family income, age, and education). Regional differences in tumor grade size and stage at diagnosis were not statistically significant; however, survival differences were observed between metropolitan and nonmetropolitan regions. An interaction between nonmetropolitan area and regional stage MBC was a significant predictor of poorer survival. Raising awareness of MBC in nonmetropolitan areas could save the lives of many men and action should be taken to improve health care access, treatment, and thus prognosis in this population.
authors.affiliation: Walden University Health Sciences, Minneapolis, MN 55401, USA. judith.klein@waldenu.edu
authors.forename: Judith
authors.initials: J
authors.lastname: Klein
authors.forename: Ming
authors.initials: M
authors.lastname: Ji
authors.forename: Nancy K
authors.initials: NK
authors.lastname: Rea
authors.forename: Georjean
authors.initials: G
authors.lastname: Stoodt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018567:Breast Neoplasms, Male / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D016009:Chi-Square Distribution; D006297:Health Services Accessibility; D006801:Humans; D015994:Incidence; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D009367:Neoplasm Staging; D011159:Population Surveillance; D011379:Prognosis; D012424:Rural Population; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D014505:Urban Population