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Evaluating Factors Associated with Advanced-Stage Breast Cancer Presentation in Rural Patients in the National Cancer

Omolade O Sogade¹, Julie A Margenthaler

¹From the Section of Surgical Oncology, Department of Surgery, Washington University in St Louis School of Medicine, St Louis, MO.

Journal of the American College of Surgeons

|March 11, 2026

Summary

Rural breast cancer patients face higher risks of late-stage diagnosis due to race and insurance status. Geographic location also impacts diagnosis, highlighting disparities in care access for rural populations.

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Area of Science:

Oncology
Public Health
Health Disparities

Background:

Breast cancer outcomes show significant disparities in rural areas, largely due to access to care barriers.
Identifying factors contributing to advanced-stage breast cancer presentation in rural populations is crucial.

Purpose of the Study:

To identify clinicopathologic factors associated with advanced-stage breast cancer diagnosis in rural patients.
To analyze the impact of demographic and geographic factors on breast cancer stage at diagnosis in rural settings.

Main Methods:

Utilized data from the National Cancer Database (NCDB) for breast cancer patients in rural areas (2004-2021).
Employed multinomial logistic regression to assess factors linked to diagnosis stage.
Analyzed clinicopathologic, demographic, and geographic variables.

Main Results:

13.6% of 52,287 rural patients were diagnosed at advanced stages.
Non-Hispanic Black and Hispanic patients faced higher risks of advanced-stage diagnosis compared to non-Hispanic white patients.
Uninsured patients exhibited a markedly higher risk of advanced-stage diagnosis, with odds increasing significantly for later stages.
Geographic variations were noted, with higher odds of stage 4 breast cancer in East South Central and West South Central regions.

Conclusions:

Geographic location, race, and insurance status are significant factors contributing to late-stage breast cancer diagnosis in rural populations.
These findings underscore the need for targeted interventions to address disparities in rural breast cancer care.
Addressing access barriers and socioeconomic factors is essential to improve outcomes for rural breast cancer patients.