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Socioeconomic background in relation to stage at diagnosis, treatment and survival in women with breast cancer

In a large population-based series of invasive breast cancer patients, we investigated socioeconomic background (SEB) in relation to (a) stage at diagnosis; (b) treatment pattern; and (c) 5-year survival. Women diagnosed during 1998–2000 and resident in the Northern and Yorkshire regions of England...

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Autores principales: Downing, A, Prakash, K, Gilthorpe, M S, Mikeljevic, J S, Forman, D
Formato: Texto
Lenguaje:English
Publicado: Nature Publishing Group 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2360059/
https://www.ncbi.nlm.nih.gov/pubmed/17311024
http://dx.doi.org/10.1038/sj.bjc.6603622
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author Downing, A
Prakash, K
Gilthorpe, M S
Mikeljevic, J S
Forman, D
author_facet Downing, A
Prakash, K
Gilthorpe, M S
Mikeljevic, J S
Forman, D
author_sort Downing, A
collection PubMed
description In a large population-based series of invasive breast cancer patients, we investigated socioeconomic background (SEB) in relation to (a) stage at diagnosis; (b) treatment pattern; and (c) 5-year survival. Women diagnosed during 1998–2000 and resident in the Northern and Yorkshire regions of England were identified from the cancer registry database (N=12 768). Logistic regression and Cox proportional hazards analyses were used to estimate associations between SEB (defined using the Townsend Index for area of residence) and tumour stage, treatment pattern, and survival. Living in a more deprived area was associated with increased likelihood of being diagnosed with stage III or IV disease (age-adjusted odds ratio (OR) 1.13; 95% confidence interval (CI) 1.08–1.18 per quartile increase in Townsend score), and, after adjustment for age and stage, reduced odds of having surgery (OR 0.85; 95% CI 0.80–0.91), and receiving radiotherapy (OR 0.91; 95% CI 0.88–0.94). Amongst patients receiving surgery, those living in more deprived areas had decreased odds of having breast conserving surgery (age plus stage-adjusted OR 0.92; 95% CI 0.89–0.95). Living in a more deprived area was also associated with increased mortality (age- plus stage-adjusted hazard ratio 1.08; 95% CI 1.05–1.11). These effects may operate through several pathways, such as later presentation leading to advanced disease.
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spelling pubmed-23600592009-09-10 Socioeconomic background in relation to stage at diagnosis, treatment and survival in women with breast cancer Downing, A Prakash, K Gilthorpe, M S Mikeljevic, J S Forman, D Br J Cancer Epidemiology In a large population-based series of invasive breast cancer patients, we investigated socioeconomic background (SEB) in relation to (a) stage at diagnosis; (b) treatment pattern; and (c) 5-year survival. Women diagnosed during 1998–2000 and resident in the Northern and Yorkshire regions of England were identified from the cancer registry database (N=12 768). Logistic regression and Cox proportional hazards analyses were used to estimate associations between SEB (defined using the Townsend Index for area of residence) and tumour stage, treatment pattern, and survival. Living in a more deprived area was associated with increased likelihood of being diagnosed with stage III or IV disease (age-adjusted odds ratio (OR) 1.13; 95% confidence interval (CI) 1.08–1.18 per quartile increase in Townsend score), and, after adjustment for age and stage, reduced odds of having surgery (OR 0.85; 95% CI 0.80–0.91), and receiving radiotherapy (OR 0.91; 95% CI 0.88–0.94). Amongst patients receiving surgery, those living in more deprived areas had decreased odds of having breast conserving surgery (age plus stage-adjusted OR 0.92; 95% CI 0.89–0.95). Living in a more deprived area was also associated with increased mortality (age- plus stage-adjusted hazard ratio 1.08; 95% CI 1.05–1.11). These effects may operate through several pathways, such as later presentation leading to advanced disease. Nature Publishing Group 2007-03-12 2007-02-20 /pmc/articles/PMC2360059/ /pubmed/17311024 http://dx.doi.org/10.1038/sj.bjc.6603622 Text en Copyright © 2007 Cancer Research UK https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/.
spellingShingle Epidemiology
Downing, A
Prakash, K
Gilthorpe, M S
Mikeljevic, J S
Forman, D
Socioeconomic background in relation to stage at diagnosis, treatment and survival in women with breast cancer
title Socioeconomic background in relation to stage at diagnosis, treatment and survival in women with breast cancer
title_full Socioeconomic background in relation to stage at diagnosis, treatment and survival in women with breast cancer
title_fullStr Socioeconomic background in relation to stage at diagnosis, treatment and survival in women with breast cancer
title_full_unstemmed Socioeconomic background in relation to stage at diagnosis, treatment and survival in women with breast cancer
title_short Socioeconomic background in relation to stage at diagnosis, treatment and survival in women with breast cancer
title_sort socioeconomic background in relation to stage at diagnosis, treatment and survival in women with breast cancer
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2360059/
https://www.ncbi.nlm.nih.gov/pubmed/17311024
http://dx.doi.org/10.1038/sj.bjc.6603622
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