Geographic barriers to early breast cancer detection in central Illinois

Even with remarkable advancements in breast cancer detection and treatment, barriers exist to obtaining regular and effective screening and treatment. This thesis investigates the following research question: what geographic, economic, and social barriers do breast cancer patients face in accessing screening and treatment services? The study area for this research is central Illinois, a region containing a mix of urban and rural settlements and an economically and socially diverse population. I focus on the breast cancer patient population served by Carle Foundation Hospital and Clinic, a major health care provider in the region, based out of Urbana, Illinois. This project utilizes a mixed methodology, which includes quantitative and qualitative components. For the quantitative component, GIS maps were created based on Carle Cancer Registry data for 2005-2009 to show the overall pattern of breast cancer cases and identify hotspots of late stage breast cancer. The maps show a clear distance decay pattern with the highest concentration of patients living in Champaign-Urbana near the main Carle hospital facility. A possible cluster of late-stage cases was observed in Villa Grove, IL, but this is most likely just a random occurrence. For the qualitative component, a survey was mailed to over 800 breast cancer patients to help understand the barriers faced in obtaining breast cancer services. The response rate was approximately 40 percent. Financial, scheduling and time management barriers were frequently cited, while geographic barriers such as transportation and weather were less important. Education and communication were common concerns, as women stated that they were not receiving clear and useful education about the disease during or after diagnosis and treatment. Recommendations for reducing these barriers are provided in the concluding chapter