Hospital Rurality and Gene Expression Profiling for Early-Stage Breast Cancer among Iowa Residents (2010–2018)

Table 1

Patient characteristics by hospital location among women with early-stage, HR+, HER2−, LN− breast cancer.

	Hospital Location			value
	Urban area	Large rural area	Small rural area
	(N = 5488)	(N = 853)	(N = 385)
	N (Column %)	N (Column %)	N (Column %)
Rural-urban residence
Urban	3839 (70.0)	6 (0.7)	14 (3.6)	<0.0001^a
Large rural	422 (7.7)	522 (61.2)	14 (3.6)
Small rural	1227 (22.4)	325 (38.1)	357 (92.7)
Age at diagnosis, years
<50	832 (15.2)	92 (10.8)	20 (5.2)	<0.0001^b
50–59	1308 (23.8)	156 (18.3)	62 (16.1)
60–69	1728 (31.5)	257 (30.1)	112 (29.1)
≥70	1620 (29.5)	348 (40.8)	191 (49.6)
Marital status at diagnosis
Married/Living with partner	3664 (66.8)	522 (61.2)	230 (59.7)	0.0003^a
Other^c/Unknown	1824 (33.2)	331 (38.8)	155 (40.3)
Insurance status
Insured^d	4981 (90.8)	777 (91.1)	344 (89.3)	0.029^a
Any Medicaid^e	309 (5.6)	55 (6.5)	18 (4.7)
Uninsured/Unknown	198 (3.6)	21 (2.4)	23 (6.0)
Median household income
<$50,000	1235 (22.5)	348 (40.8)	114 (29.6)	<0.0001^b
$50,000-$59,999	1409 (25.7)	354 (41.5)	164 (42.6)
$60,000-$69,999	1302 (23.7)	126 (14.8)	78 (20.3)
≥$70,000	1542 (28.1)	25 (2.9)	29 (7.5)
Year of diagnosis
2010–2012	1524 (27.8)	263 (30.8)	140 (36.4)	0.001^b
2013–2015	1859 (33.9)	302 (35.4)	122 (31.7)
2016–2018	2105 (38.4)	288 (33.8)	123 (31.9)
Cancer stage
I	4464 (81.3)	694 (81.4)	284 (73.8)	0.001^a
II	1024 (18.7)	159 (18.6)	101 (26.2)
Histology
Ductal	4142 (75.5)	626 (73.4)	290 (75.3)	0.019^a
Lobular	659 (12.0)	87 (10.2)	44 (11.4)
Ductal + Lobular	219 (4.0)	51 (6.0)	9 (2.3)
Mucinous	169 (3.1)	30 (3.5)	17 (4.5)
NOS/Other	299 (5.4)	59 (6.9)	25 (6.5)
Tumor size, cm
0.6–1.9	4205 (76.6)	653 (76.6)	266 (69.0)	0.013^b
2.0–4.0	1123 (20.5)	177 (20.7)	108 (28.1)
>4.0	160 (2.9)	23 (2.7)	11 (2.9)
Tumor grade
Well differentiated	2175 (39.6)	322 (37.8)	135 (35.1)	0.413^a
Moderately differentiated	2394 (43.7)	378 (44.3)	187 (48.6)
Poorly differentiated/Undifferentiated	814 (14.8)	138 (16.2)	58 (15.1)
Unknown	105 (1.9)	15 (1.7)	5 (1.2)
GEP method
Oncotype DX	2445 (44.6)	364 (42.7)	105 (27.3)	<0.0001^a
Other^f	144 (2.6)	6 (0.7)	5 (1.3)
Test not done	2899 (52.8)	483 (56.6)	275 (71.4)

Abbreviations: CM, centimeter; GEP, gene expression profiling; HER2−, human epidermal growth factor receptor 2 negative; HR+, hormone receptor-positive; LN−, lymph node negative; NOS, not otherwise specified. Bold values indicate significance at α = 0.05. -values are based on Pearson chi-square test for categorical variables. -values are based on Cochran-Mantel-Haenszel test for trend for ordered variables. ^c Divorced, separated, single, and widowed. ^d Private insurance and Medicare. ^e Indian Health Service. ^f MammaPrint, EndoPredict, BCI, and Prosigna. Bold values indicate significance at α = 0.05.