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Background Tennessee women experience the 12th highest breast cancer mortality in the United States. We examined the geographic differences in breast cancer incidence in Tennessee between Appalachian and non-Appalachian counties from 2005 to 2015. Methods We used ArcGIS 10.7 geospatial analysis and logistic regression on the Tennessee Cancer Registry incidence data for adult women aged ≥ 18 years (N = 59,287) who were diagnosed with breast cancer from 2005 to 2015 to evaluate distribution patterns by Appalachian county designation. The Tennessee Cancer Registry is a population-based, central cancer registry serving the citizens of Tennessee and was established by Tennessee law to collect and monitor cancer incidence. The main outcome was breast cancer stage at diagnosis. Independent variables were age, race, marital status, type of health insurance, and county of residence.

United statesInternational classification of diseasesTennessee department of health institutional review boardIndian health serviceTennessee department of healthEnvironmental systems research instituteHealth maintenance organizations hmosProvider organizationHealth maintenance organizationInternational classificationThird editionTennessee cancer registryTennessee departmentHealth institutional review boardAmerican indianAlaska native