Spatial Analysis of Breast Cancer Mortality Rates in a Rural State

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Map A shows the age-adjusted mortality rates (range, 6.2%–42.4%) of South Dakota counties. Values for the following counties were imputed and marked with a star: Brule, Buffalo, Butte, Deuel, Edmunds, Hamlin, Hand, Hanson, Hutchinson, Jerauld, Marshall, Mcpherson, Miner, Sanborn, and Todd. The highest mortality rates were found in Perkins, Corson, Mellette, Aurora, and Douglas; Ziebach and Jackson had the lowest. Map B shows the incidence rates (range, 48.5 to 167.3 per 100,000 people) of each South Dakota county. Potter, Sully, Kingsbury, and Haakon counties had the highest incidence rates, and Ziebach and Jones counties had the lowest.

Figure 1.
Map A shows the age-adjusted breast cancer mortality rates and Map B shows the age-adjusted breast cancer incidence rates, by county (N = 66), South Dakota, 2008–2017. Counties whose mortality rates have been imputed are marked with a star. Source: South Dakota State Cancer Registry, South Dakota Department of Health (12).

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Counties with darker shading had higher SIR values, indicating that the difference between observed and expected cases was greater than expected; counties with lighter shading had lower SIR values, indicating that the difference was less than expected.

Figure 2.
Map A shows the predicted breast cancer mortality rate of South Dakota counties, accounting for age-adjustment of the data, and Map B shows the predicted breast cancer mortality rate of South Dakota counties, accounting for age-adjustment, incidence rate, and educational attainment. Abbreviation: SIR, standardized incidence ratio. Map Sources: South Dakota State Cancer Registry, South Dakota Department of Health (12), Holzhauser et al (13), and the US Census Bureau (8).

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