Spatial Distribution of Breast Cancer in Morocco and the Impact of Travel Distance and Rural Residence on Cancer Stage

Abstract

Introduction: Breast cancer is the most common cancer among women worldwide, and its prognosis can be influenced by various factors, including geographic accessibility of healthcare services. This study describes the geographic distribution of breast cancer cases in the Casablanca-Settat region and evaluates the association between breast cancer stage at diagnosis, rural residence, and travel distance to healthcare facilities in the Casablanca-Settatregion. Methods: A retrospective hospital-based study was conducted on 2161 women diagnosed with breast cancer and admitted to Ibn Rochd University Hospital between December 2018 and January 2022. Patient residential addresses and healthcare facility locations were geocoded using Geographic Information Systems (GIS), and a straight-line distance was calculated from patients’ residences to the nearest Primary Healthcare Center (PHCC), Provincial Hospital Center (PHC), Regional Hospital Center (RHC), and University Hospital Center (UHC). Statistical analysis assessed associations between stage at diagnosis, rural/urban residence, and travel distance. Results: The overall mean distance to the UHC was 32.5 km (range: 0.19–164 km); 8.3 km (range: 0.02–83 km) to PHCs; and 1.25 km (range: 0.01–12.1 km) to PHCCs. Rural patients had longer distances to all facility types compared to urban patients. However, no significant association was found between cancer stage at diagnosis and rural residence or long travel distance to healthcare facilities (p > 0.05). Conclusions: The stage of breast cancer at diagnosis appears not to be influenced by travel distance to healthcare facilities or by rural residence.