title: Efficient mapping and geographic disparities in breast cancer mortality at the county-level by race and age in the U.S.
abstract: This study identified geographic disparities in breast cancer mortality across the U.S. using kriging to overcome unavailability of data because of confidentiality and reliability concerns. A structured additive regression model was used to detect where breast cancer mortality rates were elevated across nine divisions with 3109 U.S. counties during 1982-2004. Our analysis identified at least 25.8% of counties where breast cancer mortality rates were elevated. High-risk counties compared to lower-risk counties had higher relative risks for African American women than for White women. Greater geographic disparities more likely present in African American women and younger women. To sum up, our statistical approach reduced the impact of unavailable data, and identified the number and location of counties with high breast cancer mortality risk by race and age across the U.S.
authors.affiliation: Department of Internal Medicine, Division of Health Behavior Research, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 6700, St. Louis, MO 63108, USA. lchien@dom.wustl.edu
authors.forename: Lung-Chang
authors.initials: LC
authors.lastname: Chien
authors.forename: Hwa-Lung
authors.initials: HL
authors.lastname: Yu
authors.forename: Mario
authors.initials: M
authors.lastname: Schootman
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000208:ethnology / Q000401:mortality*; D005260:Female; D062305:Geographic Mapping; D062306:Geography, Medical; D006801:Humans; D008875:Middle Aged; D015233:Models, Statistical; D044469:Racial Groups; D012044:Regression Analysis; D062206:Spatial Analysis; D014481:United States / Q000453:epidemiology