title: Breast cancer in Mississippi: impact of race and residential geographical setting on cancer at initial diagnosis.
abstract: OBJECTIVE
  To analyze female breast cancer data for Mississippi from 2005 to 2009 to test whether race and/or geography had an impact on the stage of breast cancer at the time of diagnosis.
  
  
  METHODS
  A cross-sectional design for data was developed and collected by the Mississippi Cancer Registry (MCR). The MCR dataset contained female breast cancer cases diagnosed between 2005 and 2009. Of the 9699 cases used, 2925 were white patients living in urban counties and 3584 were white patients residing in a rural county. Among African American patients, 1247 lived in urban areas, and 1943 resided in rural counties.
  
  
  RESULTS
  Geography had a significant impact on the stage of breast cancer at which the patient was diagnosed. Women living in rural Mississippi had a greater chance (white 4% and African American 19%) of presenting with advanced regional/distant breast cancer rather than in situ/localized breast cancer. The number of white patients was similar to the number of African American patients who presented at the time of diagnosis with advanced regional/distant breast cancer. African American women had greater odds than white women (urban 25%, rural 47%) of presenting with advanced regional/distant breast cancer.
  
  
  CONCLUSIONS
  This study provides important new information about two specific factors that may affect the stage of breast cancer diagnosis: race (whites vs African Americans) and geography (urban vs rural county). The implications of this study will aid the Mississippi State Department of Health in targeting screening programs throughout the state. The results also may affect medical and allied health care.
authors.affiliation: From the Department of Physician Relations, the School of Health-Related Professions, and the Department of Radiology, University of Mississippi Medical Center, Jackson.
authors.forename: Kathleen Mechelle
authors.initials: KM
authors.lastname: Keeton
authors.affiliation: From the Department of Physician Relations, the School of Health-Related Professions, and the Department of Radiology, University of Mississippi Medical Center, Jackson.
authors.forename: Ellen S
authors.initials: ES
authors.lastname: Jones
authors.affiliation: From the Department of Physician Relations, the School of Health-Related Professions, and the Department of Radiology, University of Mississippi Medical Center, Jackson.
authors.forename: Sunit
authors.initials: S
authors.lastname: Sebastian
mesh_terms: D001741:Black or African American; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008922:Mississippi / Q000453:epidemiology; D009367:Neoplasm Staging; D044469:Racial Groups; D012424:Rural Population; D014505:Urban Population; D044465:White People