Where is America’s best access to breast cancer care?

Diagnosis and treatment are crucial to breast cancer survival. But access to the best diagnosticians and specialists isn’t equal across our nation.

Luckily, access to preventative screenings is increasing under the Affordable Care Act. Health plans must cover mammograms for women 40 and over, as well as those who are high-risk. Despite that, gaps remain in the quality of care being delivered and the number of experienced specialists available.

Vitals’ first annual America’s Top States for Access to Breast Cancer Care paired statistics from Vitals’ vast doctor database with publicly available demographic data available on incident rates of breast cancer.

Several doctors – from gynecologists to oncologists, radiologists to plastic surgeons – focus on treating women with breast cancer, but they are often unevenly distributed. For instance, the study revealed that the ratio of breast cancer patients to specialists was best in Missouri (20:1), Massachusetts (25:1) and Maryland (27:1). In contrast, the ratio of patients to breast cancer specialists in Alaska is 200 to 1. Mississippi (144:1) and Hawaii (104:1) also had high patient to doctor ratios.

Access to Breast Cancer Specialists (by incident of breast cancer)

State No. of specialists Avg Incidence (per 100,000) Patients per Specialist Rank
MO 163 112.1 20.6 1
MA 379 140.5 24.8 2
MD 274 126 27.3 3
RI 47 126 28.2 4
VT 27 126 29.2 5


AK 5 140.5 206.5 50
MS 51 121.3 143.8 49
HI 17 126 104.1 48
ID 18 112.1 100.4 47
AR 37 112.1 89.7 46

In addition, patient-reported metrics such as doctor ratings and ease in getting an appointment were calculated into the final rankings. A good doctor-patient relationship has been shown to effect outcomes with patients. And at no time are the consequences more dire than when dealing with cancer.

The final results did not show any geographic relevance, but did match up to poverty data from the states. Seven out of the bottom 10 from the Vitals’ survey are also among the poorest states in the nation.

Economic factors have been linked to when women get diagnosed with breast cancer in several medical studies. Poverty-stricken women are more likely to wait before seeking treatment because of the cost of care or time spent away from family and jobs.

Maine’s poverty rate is #33, while Mississippi is #50 – the worst in the nation. In contrast, Vermont, which ranked at the top of the Vitals’ survey, has the third lowest poverty rate in the nation.

To view the full list of state rankings, see the press release.

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