Rural-urban disparities of breast cancer patients in China

The purpose of this study was to examine the rural-urban disparities in breast cancer patients in China. The retrospective study was performed with a total of 2,139 breast cancer patients hospitalized in Qilu Hospital of Shandong University between the years 1997 and 2011. We applied Chi-square analysis to identify significant disparities between rural and urban populations. Logistic regression model was used to estimate factors associated with the adjuvant chemotherapy treatment. Two-fifths of patients were considered rural dwellers. Significant disparities were found in marriage age (p < 0.0001), history of breast cancer (p = 0.0187), smoking (p = 0.0025) and reason for visiting a doctor (p < 0.0001) among all demographic variables. Rural patients tend to suffer more aggressive tumor histology (p = 0.0251), larger tumor size (p < 0.0001) and more metastatic lymph nodes (p < 0.0001) than urban patients. In addition, rural-urban differences were also shown in the choice of neo-adjuvant chemotherapy (p = 0.0050) and surgical procedures (p < 0.0001). With logistic regression model, we found some significant factors associated with the choice of post-adjuvant chemotherapy, including age at diagnosis, history of breast cancer, tumor histology and number of positive lymph node. Differences in rural-urban breast cancer patients exist in China. Interventions to increase early diagnosis of breast cancer among rural area are in need. Further research is needed to investigate potential attitude and perception differences between rural and urban populations with respect to breast cancer preventions and treatments.