Travel burden increases the risk of advanced stage at diagnosis of breast cancer in Kashgar, China

Abstract Early breast cancer detection rates are low in Kashgar, Xinjiang, China, potentially due to poor spatial accessibility to diagnostic services. This study examined the association between travel burden from patient residences to hospitals and the stage of breast cancer at diagnosis in this population. We analyzed data from 981 female patients (aged > 20 years) diagnosed with breast cancer at the First People’s Hospital of Kashgar between 2019 and 2022. Driving distances were calculated using the Baidu Maps API. Multivariable multinomial and binary logistic regression models were used. 29.9% of the sample were diagnosed at an advanced stage of disease. Residing more than 20 km from secondary hospitals increased the relative risk of advanced-stage diagnosis by 1.61-fold (95% CI: 1.20–2.31, vs. early-stage) and the odds by 1.48 times (95% CI: 1.07–2.05, vs. non-advanced stage). Similarly, living more than 80 km from tertiary hospitals was associated with an elevated relative risk (RRR = 1.38; 95% CI: 1.08–1.75, vs. early-stage) and 1.40 times the odds (95% CI: 1.04–1.90, vs. non-advanced stage) of advanced-stage diagnosis. Longer travel distances to both secondary and tertiary hospitals are associated with increased risks of advanced-stage breast cancer at diagnosis in Kashgar. Enhancing spatial accessibility to diagnostic services is crucial for improving early detection and potentially downstaging breast cancer in this and similar remote regions.