title: The geographic distribution of mammography resources in Mississippi.
abstract: OBJECTIVE
  To determine whether the availability of mammography resources affected breast cancer incidence rates, stage of disease at initial diagnosis, mortality rates and/or mortality-to-incidence ratios throughout Mississippi.
  
  
  METHODS
  Mammography facilities were geocoded and the numbers of residents residing within a thirty minute drive of a mammography facility were calculated. Other data were extracted from the Mississippi Cancer Registry, the U.S. Census, and the Mississippi Behavioral Risk Factor Surveillance Survey (BRFSS).
  
  
  CONCLUSIONS
  There were no statistically-significant differences between breast cancer incidence rates in Black versus White females in Mississippi; however, there were significant differences in the use of mammography, percentages of advanced-stage initial diagnoses, mortality rates, and mortality-to-incidence ratios, where Black females fared worse in each category. No statistically-significant correlations were observed between breast cancer outcomes and the availability of mammography facilities. The use of mammography was negatively correlated with advanced stage of disease at initial diagnosis. By combining Black and White subsets, a correlation between mammography use and improved survival was detected; this was not apparent in either subset alone. There was also a correlation between breast cancer mortality-to-incidence ratios and the percentage of the population living below the poverty level.
  
  
  CONCLUSIONS
  The accessibility and use of mammography resources has a greater impact on breast cancer in Mississippi than does the geographic resource distribution per se. Therefore, intensified mammography campaigns to reduce the percentage of advanced-stage breast cancers initially diagnosed in Black women, especially in communities with high levels of poverty, are warranted in Mississippi.
authors.affiliation: Murrah High School, Jackson, MS 39216, USA.
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Nichols
authors.affiliation: Murrah High School, Jackson, MS 39216, USA.
authors.forename: Denae L
authors.initials: DL
authors.lastname: Bradley
authors.affiliation: Center of Biostatistics & Bioinformatics, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA.
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
authors.affiliation: GIS & Remote Sensing Program, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA.
authors.forename: Fazlay
authors.initials: F
authors.lastname: Faruque
authors.affiliation: Department of Pharmacology and Toxicology & Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA.
authors.forename: Roy J
authors.initials: RJ
authors.lastname: Duhé
keywords: Breast Cancer; Geographic Information System (GIS); Health Disparities; Mammography