geographical proximity to health facilities and breast cancer

Introduction: Death rates for breast cancer have steadily decreased in women due to early detection, such as mammography, and improved treatments. Breast cancer is a major contributor to morbidity and mortality among women. The purpose of this study is to examine whether travel distance to the screening provider and mammography facility are associated with completion of abnormal mammography follow-up, breast cancer stage at diagnosis, and mortality among women.Method: The study was reviewed by searching scientific articles and books and resources have been made. Results: Despite the benefit of mammography, many women are not up-to-date on screening and about 38%-54% do not maintain annual adherence to screening mammograms.Inadequate screening and follow-up are associated with late stage breast cancer at diagnosis, which lead to poor survival. About 9%-15% of women who receive mammography screening have an abnormal finding that require further testing, and approximately 30% -50% will delay follow-up testing . Women who delay follow-up testing increase the risk of having larger tumor size, late-stage breast cancer at diagnosis, and poorer prognosis. Factors contributing to inadequate or incomplete abnormal mammogram follow-up include: fear, language barrier, race/ethnicity, lack of provider, income level, and education. The patient, provider, and system can all contribute to adequate follow -up. Travel barriers, such as long travel distance, can discourage women to seek routine preventive care or screening. A common measurement of spatial accessibility is travel distance or travel time from a residential place to the closest facility. Women who lived farther from their diagnosing mammography facility had longer day to resolution compared to those who lived the closest. Travel distance from patient’s residence to the diagnosing mammography facility may have an impact on the completion of abnormal mammographic finding. Conclusion: Intervention strategies and additional support to the program to expand services should be investigated to reduce the disparity in days to completion of abnormal mammographic.

Keywords:

Breast cancer , Health facilities , Geographical proximity