title: Rural-urban disparities in stage of breast cancer at diagnosis in Australian women.
abstract: OBJECTIVE
  To examine urban-rural differences and individual risk factors for a late stage of breast cancer at diagnosis in Australian women.
  
  
  METHODS
  Individual-level longitudinal data were linked with cancer registry data from New South Wales (New South Wales Cancer Registry linked by the Centre for Health Record Linkage (CHeReL)), Queensland (Queensland Cancer Registry) and Victoria (The Cancer Council Victoria).
  
  
  METHODS
  Participants were drawn from the Australian Longitudinal Study on Women's Health 1946-1951 cohort (n = 13 715).
  
  
  METHODS
  The sample included 195 women identified from the linked cancer registry data with a breast cancer diagnosis.
  
  
  METHODS
  Rural or urban residence was measured using Accessibility/Remoteness Index of Australia Plus (ARIA+). Individual characteristics and socio-demographic variables examined included survey year, menopausal status, country of birth, education and marital status.
  
  
  METHODS
  A late stage of breast cancer at diagnosis was defined based on the TNM Classification of Malignant Tumours.
  
  
  RESULTS
  A late stage of breast cancer diagnosis was observed in 36% of women residing in urban areas and 40% of women residing in rural areas. After adjusting for individual characteristics, we found that obesity was the strongest risk factor for a late stage of breast cancer at diagnosis.
  
  
  CONCLUSIONS
  Given that women are becoming increasingly obese, and that the rate of obesity is higher in the Australian rural population, this paper provides further evidence for targeting interventions for obesity, particularly in rural Australia, as a public health priority.
authors.affiliation: School of Public Health, The University of Queensland, Brisbane, Queensland, Australia. j.leung1@uq.edu.au.|Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia. j.leung1@uq.edu.au.
authors.forename: Janni
authors.initials: J
authors.lastname: Leung
authors.affiliation: School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.|School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Martin
authors.affiliation: School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Deirdre
authors.initials: D
authors.lastname: McLaughlin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D001943:Breast Neoplasms / Q000175:diagnosis*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009517:New South Wales; D012042:Registries; D012424:Rural Population; D014505:Urban Population; D016387:Women's Health; D055815:Young Adult
keywords: body mass index; body weight; cancer; diagnosis; rural health