Geographical inequalities in surgical treatment for localized female breast cancer, Queensland, Australia 1997–2011: improvements over time but inequalities remain

Baade, Peter D., Dasgupta, Paramita, Youl, Philippa H., Pyke, Christopher and Aitken, Joanne F. (2016) Geographical inequalities in surgical treatment for localized female breast cancer, Queensland, Australia 1997–2011: improvements over time but inequalities remain. International Journal of Environmental Research and Public Health, 13 7: . doi:10.3390/ijerph13070729


Author Baade, Peter D.
Dasgupta, Paramita
Youl, Philippa H.
Pyke, Christopher
Aitken, Joanne F.
Title Geographical inequalities in surgical treatment for localized female breast cancer, Queensland, Australia 1997–2011: improvements over time but inequalities remain
Journal name International Journal of Environmental Research and Public Health   Check publisher's open access policy
ISSN 1660-4601
1661-7827
Publication date 2016-07-19
Sub-type Article (original research)
DOI 10.3390/ijerph13070729
Open Access Status DOI
Volume 13
Issue 7
Total pages 14
Place of publication Basel, Switzerland
Publisher M D P I AG
Collection year 2017
Language eng
Formatted abstract
The uptake of breast conserving surgery (BCS) for early stage breast cancer varies by where women live. We investigate whether these geographical patterns have changed over time using population-based data linkage between cancer registry records and hospital inpatient episodes. The study cohort consisted of 11,631 women aged 20 years and over diagnosed with a single primary invasive localised breast cancer between 1997 and 2011 in Queensland, Australia who underwent either BCS (n = 9223, 79%) or mastectomy (n = 2408, 21%). After adjustment for socio-demographic and clinical factors, compared to women living in very high accessibility areas, women in high (Odds Ratio (OR) 0.58 (95% confidence intervals (CI) 0.49, 0.69)), low (OR 0.47 (0.41, 0.54)) and very low (OR 0.44 (0.34, 0.56)) accessibility areas had lower odds of having BCS, while the odds for women from middle (OR 0.81 (0.69, 0.94)) and most disadvantaged (OR 0.87 (0.71, 0.98)) areas was significantly lower than women living in affluent areas. The association between accessibility and the type of surgery reduced over time (interaction p = 0.028) but not for area disadvantage (interaction p = 0.209). In making informed decisions about surgical treatment, it is crucial that any geographical-related barriers to implementing their preferred treatment are minimised.
Keyword Breast cancer
Breast conserving surgery
Geography
Inequalities
Mastectomy
Socioeconomic
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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