Geographic remoteness, area-level socio-economic disadvantage and advanced breast cancer: a cross-sectional, multilevel study.
| Autor: | Baade, Peter D., Turrell, Gavin, Aitken, Joanne F. |
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| Předmět: |
BREAST tumor diagnosis
BREAST tumor risk factors ANALYSIS of variance CHI-squared test CONFIDENCE intervals REPORTING of diseases EPIDEMIOLOGY MATHEMATICAL models MEDICALLY underserved areas POPULATION geography RESEARCH funding STATISTICS TUMOR classification DATA analysis SOCIOECONOMIC factors CROSS-sectional method |
| Zdroj: | Journal of Epidemiology & Community Health; Nov2011, Vol. 65 Issue 11, p1037-1043, 7p, 2 Charts |
| Abstrakt: | 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 area and individual-level contributions to the risk of advanced breast cancer among women aged 30-79 years diagnosed as having breast cancer in Queensland, Australia between 1997 and 2006 (n=18 658). 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 individual-level factors. When geographic remoteness and area-disadvantage (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. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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