Next Article in Journal
Modeling Fire Occurrence at the City Scale: A Comparison between Geographically Weighted Regression and Global Linear Regression
Next Article in Special Issue
Geospatial Analysis of Inflammatory Breast Cancer and Associated Community Characteristics in the United States
Previous Article in Journal
Disparities in HIV Clinical Outcomes among a Cohort of HIV-Infected Persons Receiving Care—Mississippi
Previous Article in Special Issue
Hispanic and Immigrant Paradoxes in U.S. Breast Cancer Mortality: Impact of Neighborhood Poverty and Hispanic Density
Article Menu
Issue 4 (April) cover image

Export Article

Open AccessArticle
Int. J. Environ. Res. Public Health 2017, 14(4), 394;

Urban–Rural Variations in Quality-of-Life in Breast Cancer Survivors Prescribed Endocrine Therapy

Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland
Office of Planning & Analysis, University of California, Berkeley, CA 94720, USA
Division of Psychology, University of Stirling, Stirling FK9 4LA, UK
Institute of Health and Society, Newcastle University, Newcastle NE1 7RU, UK
Author to whom correspondence should be addressed.
Academic Editor: Peter Baade
Received: 27 February 2017 / Revised: 31 March 2017 / Accepted: 5 April 2017 / Published: 7 April 2017
(This article belongs to the Special Issue Geographical Variation in Breast Cancer Outcomes)
Full-Text   |   PDF [311 KB, uploaded 7 April 2017]


The number of breast cancer survivors has increased as a result of rising incidence and increased survival. Research has revealed significant urban–rural variation in clinical aspects of breast cancer but evidence in the area of survivorship is limited. We aimed to investigate whether quality of life (QoL) and treatment-related symptoms vary between urban and rural breast cancer survivors prescribed endocrine therapy. Women with a diagnosis of stages I–III breast cancer prescribed endocrine therapy were identified from the National Cancer Registry Ireland and invited to complete a postal survey (N = 1606; response rate = 66%). A composite measure of urban–rural classification was created using settlement size, population density and proximity to treatment hospital. QoL was measured using the Functional Assessment of Cancer Therapy (FACT-G) and an endocrine subscale. The association between urban–rural residence/status and QoL and endocrine symptoms was assessed using linear regression with adjustment for socio-demographic and clinical covariates. In multivariable analysis, rural survivors had a statistically significant higher overall QoL (β = 3.81, standard error (SE) 1.30, p < 0.01), emotional QoL (β = 0.70, SE 0.21, p < 0.01) and experienced a lower symptom burden (β = 1.76, SE 0.65, p < 0.01) than urban survivors. QoL in breast cancer survivors is not simply about proximity and access to healthcare services but may include individual and community level psychosocial factors. View Full-Text
Keywords: urban; rural; quality of life; breast cancer; survivorship; endocrine therapy urban; rural; quality of life; breast cancer; survivorship; endocrine therapy
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Share & Cite This Article

MDPI and ACS Style

Cahir, C.; Thomas, A.A.; Dombrowski, S.U.; Bennett, K.; Sharp, L. Urban–Rural Variations in Quality-of-Life in Breast Cancer Survivors Prescribed Endocrine Therapy. Int. J. Environ. Res. Public Health 2017, 14, 394.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics



[Return to top]
Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top