Relationship between Health Inequalities and Breast Cancer Survival in Mexican Women

Autor: Isabel Sollozo-Dupont, Victor Jesús Lara-Ameca, Dulce Cruz-Castillo, Yolanda Villaseñor-Navarro
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: International Journal of Environmental Research and Public Health; Volume 20; Issue 7; Pages: 5329
ISSN: 1660-4601
DOI: 10.3390/ijerph20075329
Popis: Objective: We aimed to analyze the relationship between the survival of patients with breast cancer and health inequalities. Methods: A retrospective cohort study of women with stage III breast cancer according to public healthcare was conducted. Groups were stratified according to the course of treatment and the presence of chronic disease other than cancer. Survival functions were estimated by using the Kaplan–Meier estimator, while the Cox proportional hazards model was employed for prognostic assessment. Results: The study was performed on 964 breast cancer patients. One hundred and seventy-six patients (18.23%) died during the follow-up period and 788 (81.77%) were alive at the end of the follow-up period. Education, marital status, personal history of prior biopsies, and socioeconomic status (SES) were found to be linked with survival. However, only SES exceeded the baseline risk of mortality when the treatment cycle was interrupted (full treatment: unadjusted 4.683, p = 0.001; adjusted 4.888 p = 0.001, partial treatment: unadjusted 1.973, p = 0.012; adjusted 4.185, p = 0.001). The same effect was observed when stratifying by the presence of chronic disease other than cancer (with chronic disease adjusted HR = 4.948, p = 0.001; unadjusted HR = 3.303, p = 0.001; without chronic disease adjusted HR = 4.850, p = 0.001; unadjusted HR = 5.121, p = 0.001). Conclusion: Since lower SES was linked with a worse prognosis, strategies to promote preventive medicine, particularly breast cancer screening programs and prompt diagnosis, are needed.
Databáze: OpenAIRE