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Socioeconomic Disparity in Survival after Breast Cancer in Ireland: Observational Study
We evaluated the relationship between breast cancer survival and deprivation using data from the Irish National Cancer Registry. Cause-specific survival was compared between five area-based socioeconomic deprivation strata using Cox regression. Patient and tumour characteristics and treatment were c...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221110/ https://www.ncbi.nlm.nih.gov/pubmed/25372837 http://dx.doi.org/10.1371/journal.pone.0111729 |
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author | Walsh, Paul M. Byrne, Julianne Kelly, Maria McDevitt, Joe Comber, Harry |
author_facet | Walsh, Paul M. Byrne, Julianne Kelly, Maria McDevitt, Joe Comber, Harry |
author_sort | Walsh, Paul M. |
collection | PubMed |
description | We evaluated the relationship between breast cancer survival and deprivation using data from the Irish National Cancer Registry. Cause-specific survival was compared between five area-based socioeconomic deprivation strata using Cox regression. Patient and tumour characteristics and treatment were compared using modified Poisson regression with robust variance estimation. Based on 21356 patients diagnosed 1999–2008, age-standardized five-year survival averaged 80% in the least deprived and 75% in the most deprived stratum. Age-adjusted mortality risk was 33% higher in the most deprived group (hazard ratio 1.33, 95% CI 1.21–1.45, P<0.001). The most deprived groups were more likely to present with advanced stage, high grade or hormone receptor-negative cancer, symptomatically, or with significant comorbidity, and to be smokers or unmarried, and less likely to have breast-conserving surgery. Cox modelling suggested that the available data on patient, tumour and treatment factors could account for only about half of the survival disparity (adjusted hazard ratio 1.18, 95% CI 0.97–1.43, P = 0.093). Survival disparity did not diminish over time, compared with the period 1994–1998. Persistent survival disparities among Irish breast cancer patients suggest unequal use of or access to services and highlight the need for further research to understand and remove the behavioural or other barriers involved. |
format | Online Article Text |
id | pubmed-4221110 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-42211102014-11-12 Socioeconomic Disparity in Survival after Breast Cancer in Ireland: Observational Study Walsh, Paul M. Byrne, Julianne Kelly, Maria McDevitt, Joe Comber, Harry PLoS One Research Article We evaluated the relationship between breast cancer survival and deprivation using data from the Irish National Cancer Registry. Cause-specific survival was compared between five area-based socioeconomic deprivation strata using Cox regression. Patient and tumour characteristics and treatment were compared using modified Poisson regression with robust variance estimation. Based on 21356 patients diagnosed 1999–2008, age-standardized five-year survival averaged 80% in the least deprived and 75% in the most deprived stratum. Age-adjusted mortality risk was 33% higher in the most deprived group (hazard ratio 1.33, 95% CI 1.21–1.45, P<0.001). The most deprived groups were more likely to present with advanced stage, high grade or hormone receptor-negative cancer, symptomatically, or with significant comorbidity, and to be smokers or unmarried, and less likely to have breast-conserving surgery. Cox modelling suggested that the available data on patient, tumour and treatment factors could account for only about half of the survival disparity (adjusted hazard ratio 1.18, 95% CI 0.97–1.43, P = 0.093). Survival disparity did not diminish over time, compared with the period 1994–1998. Persistent survival disparities among Irish breast cancer patients suggest unequal use of or access to services and highlight the need for further research to understand and remove the behavioural or other barriers involved. Public Library of Science 2014-11-05 /pmc/articles/PMC4221110/ /pubmed/25372837 http://dx.doi.org/10.1371/journal.pone.0111729 Text en © 2014 Walsh et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Walsh, Paul M. Byrne, Julianne Kelly, Maria McDevitt, Joe Comber, Harry Socioeconomic Disparity in Survival after Breast Cancer in Ireland: Observational Study |
title | Socioeconomic Disparity in Survival after Breast Cancer in Ireland: Observational Study |
title_full | Socioeconomic Disparity in Survival after Breast Cancer in Ireland: Observational Study |
title_fullStr | Socioeconomic Disparity in Survival after Breast Cancer in Ireland: Observational Study |
title_full_unstemmed | Socioeconomic Disparity in Survival after Breast Cancer in Ireland: Observational Study |
title_short | Socioeconomic Disparity in Survival after Breast Cancer in Ireland: Observational Study |
title_sort | socioeconomic disparity in survival after breast cancer in ireland: observational study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221110/ https://www.ncbi.nlm.nih.gov/pubmed/25372837 http://dx.doi.org/10.1371/journal.pone.0111729 |
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