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. Author manuscript; available in PMC: 2024 Apr 2.
Published in final edited form as: Cancer Epidemiol Biomarkers Prev. 2023 Oct 2;32(10):1302–1311. doi: 10.1158/1055-9965.EPI-23-0421

Table 3.

Adverse Health Outcomes Overall, at 1–5 Years and >5 Years After the Initial Year From Breast Cancer Diagnosis in Rural Compared to Urban (reference) Breast Cancer Survivors Diagnosed in 1997–2017 a

Overall 1 to 5 years >5 years
Rural N = 2,359 Urban N = 11,748 Rural N = 2,359 Urban N = 11,748 Rural N = 1,386 Urban N = 7,145
No. (%) No. (%) HR b (99%CI) No. (%) No. (%) HR b (99%CI) No. (%) No. (%) HR b (99%CI)
Anemia 444 (24.1) 1,916 (26.8) 0.93 (0.80, 1.07) 256 (13.9) 1,063 (14.9) 0.94 (0.78, 1.14) 195 (19.5) 666 (21.9) 0.91 (0.73, 1.15)
Anxiety disorders 399 (21.5) 1,552 (20.8) 1.12 (0.95, 1.31) 227 (12.2) 782 (10.5) 1.18 (0.97, 1.45) 172 (15.3) 812 (20.8) 1.02 (0.80, 1.29)
Atrial fibrillation and flutter 245 (11.1) 1,010 (9.8) 1.10 (0.90, 1.34) 97 (4.4) 445 (4.3) 0.96 (0.71, 1.29) 156 (15.0) 463 (28.0) 1.20 (0.93, 1.57)
Cataracts 333 (16.0) 1,972 (21.8) 0.66 (0.56, 0.78) 165 (7.9) 949 (10.5) 0.67 (0.54, 0.85) 149 (15.0) 521 (18.2) 0.63 (0.50, 0.80)
Depression, bipolar, other mood disorders 373 (20.6) 1,501 (21.8) 0.96 (0.82, 1.13) 230 (12.7) 844 (12.3) 1.01 (0.81, 1.25) 161 (13.0) 504 (10.8) 0.84 (0.65, 1.09)
Diabetes 258 (13.1) 1,075 (13.0) 1.05 (0.87, 1.28) 142 (7.2) 561 (6.8) 1.10 (0.85, 1.42) 215 (26.5) 616 (28.5) 0.98 (0.75, 1.30)
Hearing impairments 119 (7.7) 839 (5.2) 0.68 (0.52, 0.90) 58 (2.5) 364 (3.3) 0.77 (0.53, 1.12) 198 (15.9) 767 (16.6) 0.62 (0.43, 0.91)
Heart failure and non-ischemic heart disease 311 (14.6) 1,156 (11.6) 1.27 (1.06, 1.53) 159 (7.4) 560 (5.6) 1.39 (1.02, 1.65) 181 (30.1) 441 (27.1) 1.23 (0.95, 1.59)
Hip or pelvic fracture 125 (5.4) 553 (4.9) 1.18 (0.89, 1.57) 63 (2.7) 277 (2.4) 1.15 (0.79, 1.68) 63 (4.7) 202 (3.8) 1.28 (0.95, 1.93)
Hyperlipidemia 391 (25.2) 1,645 (29.6) 0.81 (0.69, 0.96) 198 (12.7) 860 (15.5) 0.78 (0.63, 0.97) 138 (11.5) 494 (11.4) 0.90 (0.71, 1.13)
Hypertension 375 (31.7) 1,171 (29.6) 1.03 (0.87, 1.23) 193 (16.3) 595 (15.0) 1.02 (0.81, 1.28) 168 (15.0) 612 (16.5) 1.07 (0.82, 1.38)
Hypothyroidism 293 (16.2) 1,088 (15.8) 1.06 (0.88, 1.28) 162 (9.0) 623 (9.1) 1.03 (0.81, 1.30) 144 (14.8) 368 (12.7) 1.12 (0.84, 1.48)
Ischemic heart disease 254 (12.1) 1,173 (12.4) 0.95 (0.78, 1.15) 121 (5.8) 568 (6.0) 0.91 (0.70, 1.20) 98 (7.6) 382 (7.7) 1.01 (0.77, 1.32)
Osteoporosis 355 (17.0) 1,773 (19.4) 0.85 (0.72, 1.00) 198 (9.5) 991 (10.9) 0.84 (0.69, 1.04) 185 (17.5) 596 (18.0) 0.89 (0.69, 1.13)
Stroke or transient ischemic attack 188 (8.4) 880 (8.3) 0.98 (0.78, 1.22) 93 (4.1) 417 (3.9) 1.02 (0.76, 1.39) 63 (4.8) 368 (7.4) 0.93 (0.68, 1.27)

Abbreviations: HR, hazard ratio; CI, confidence interval.

a

The number and percent for each outcome excluded prevalent cases. Urban breast cancer survivors were matched to rural breast cancer survivors on cancer diagnosis year and age at cancer diagnosis.

b

Models were adjusted for the matching factors, race, and ethnicity.

c

Flexible model was used where the proportional hazards assumption was violated for 1 to 5 years for Depression, bipolar, and other mood disorders (HR = 1.00, 99%CI 0.83, 1.21); for >5 years for Hyperlipidemia (HR = 0.87, 99%CI 0.72, 1.06), Stroke or transient ischemic attack (HR = 1.03, 99%CI 0.77, 1.37), and Anxiety disorders (HR = 0.99, 99%CI 0.81, 1.22).