Socioeconomic and demographic disparities in breast cancer stage at presentation and survival: A Swiss population-based study
| Autor: | Feller, Anita, Schmidlin, Kurt, Bordoni, Andrea, Bouchardy, Christine, Bulliard, Jean-Luc, Camey, Bertrand, Konzelmann, Isabelle, Maspoli, Manuela, Wanner, Miriam, Clough-Gorr, Kerri M |
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| Přispěvatelé: | University of Zurich, Feller, Anita, SNC and the NICER workinggroup |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Aged 80 and over Cancer Research Age Factors Breast Neoplasms 610 Medicine & health Health Status Disparities 10060 Epidemiology Biostatistics and Prevention Institute (EBPI) breast cancer health inequalities incidence socioeconomic position survival Middle Aged Socioeconomic Factors Oncology Humans Female 2730 Oncology 1306 Cancer Research Switzerland Aged Neoplasm Staging SEER Program ddc:613 |
| Zdroj: | International Journal of Cancer, Vol. 141, No 8 (2017) pp. 1529-1539 International journal of cancer, vol. 141, no. 8, pp. 1529-1539 |
| ISSN: | 0020-7136 |
| Popis: | We explored socioeconomic and demographic disparities in breast cancer (BC) stage at presentation and survival in a Swiss population-based sample of female BC patients linked to the census-based Swiss National Cohort. Tumor stage was classified according to Surveillance, Epidemiology and End Results Program summary stage (in situ/localized/regional/distant). We used highest education level attained to estimate SEP (low/middle/high). Further demographic characteristics of interest were age at presentation (30-49/50-69/70-84 years), living in a canton with organized screening (yes/no), urbanity of residence (urban/peri-urban/rural), civil status (single/married/widowed/divorced) and nationality (Swiss/non-Swiss). We used ordered logistic regression models to analyze factors associated with BC stage at presentation and competing risk regression models for factors associated with survival. Odds of later-stage BC were significantly increased for low SEP women (odds ratio 1.19, 95%CI 1.06-1.34) compared to women of high SEP. Further, women living in a canton without organized screening program, women diagnosed outside the targeted screening age and single/widowed/divorced women were more often diagnosed at later stages. Women of low SEP experienced an increased risk of dying from BC (sub-hazard ratio 1.22, 95%CI 1.05-1.43) compared to women of high SEP. Notably, these survival inequalities could not be explained by socioeconomic differences in stage at presentation and/or other sociodemographic factors. It is concerning that these social gradients have been observed in a country with universal health insurance coverage, high health expenditures and one of the highest life expectancies in the world. |
| Databáze: | OpenAIRE |
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