Geographic remoteness, area-level socio-economic disadvantage and advanced breast cancer: A cross-sectional, multilevel study

Baade, Peter D., Turrell, Gavin and Aitken, Joanne F. (2011) Geographic remoteness, area-level socio-economic disadvantage and advanced breast cancer: A cross-sectional, multilevel study. Journal of Epidemiology and Community Health, 65 11: 1037-1043. doi:10.1136/jech.2010.114777


Author Baade, Peter D.
Turrell, Gavin
Aitken, Joanne F.
Title Geographic remoteness, area-level socio-economic disadvantage and advanced breast cancer: A cross-sectional, multilevel study
Journal name Journal of Epidemiology and Community Health   Check publisher's open access policy
ISSN 0143-005X
1470-2738
Publication date 2011-11-01
Sub-type Article (original research)
DOI 10.1136/jech.2010.114777
Volume 65
Issue 11
Start page 1037
End page 1043
Total pages 7
Place of publication BMJ Group
Publisher London, United Kingdom
Collection year 2012
Language eng
Formatted abstract
Background Reducing disparities in cancer outcomes is a major priority for cancer-control agencies. The authors examine the relationships between geographic remoteness, area disadvantage and risk of advanced breast cancer among women. Methods Multilevel models were used to assess the areaand individual-level contributions to the risk of advanced breast cancer among women aged 30e79 years diagnosed as having breast cancer in Queensland, Australia between 1997 and 2006 (n¼18 658).

Results Women who resided in the most socioeconomically disadvantaged areas were significantly more likely (OR 1.21, 95% CI 1.07 to 1.37) than residents of the most advantaged areas to be diagnosed as having advanced breast cancer after adjustment for individuallevel factors. When geographic remoteness and areadisadvantage (and all the individual-level factors) were simultaneously adjusted, the rates of advanced breast cancer were significantly higher for women residing in Outer Regional areas (OR 1.13, 95% CI 1.02 to 1.24) and those who lived in the most disadvantaged areas (OR 1.16, 95% CI 1.02 to 1.32). There was no statistically significant interaction between geographic remoteness and area disadvantage.

Conclusions A woman’s risk of being diagnosed as having advanced breast cancer depends on where she lives, separate from the individual characteristics of the woman herself. Both the rurality and socio-economic characteristics of the geographical area in which women lived were important. The socio-economic factors contributing to advanced breast cancer, existing in both urban and rural environments, need to be investigated.  
Keyword Indigenous Australians
United States
Diagnosis
Stage
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Public Health Publications
 
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