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Title: Increasing rates of surgical treatment and preventing comorbidities may increase breast cancer survival for Aboriginal women
Authors: Supramaniam R; Gibberd A; Dillon A; Goldsbury DE; O'Connell DL
Categories: Cancer Type - Breast Cancer
Treatment - Resources and Infrastructure
Keywords: aboriginal; mortality; New South Wales; Odds Ratio; Registries; Research; Risk; survival; Wales; Women; Australia; breast; cancer; cancer registry; cancer survival; Comorbidity; diagnosis; methods
Year: 2014
Journal Title: BMC Cancer
Volume: 14
Issue: 1
Page number start: 163
Abstract: BACKGROUND: Lower breast cancer survival has been reported for Australian Aboriginal women compared to non-Aboriginal women, however the reasons for this disparity have not been fully explored. We compared the surgical treatment and survival of Aboriginal and non-Aboriginal women diagnosed with breast cancer in New South Wales (NSW), Australia. METHODS: We analysed NSW cancer registry records of breast cancers diagnosed in 2001-2007, linked to hospital inpatient episodes and deaths. We used unconditional logistic regression to compare the odds of Aboriginal and non-Aboriginal women receiving surgical treatment. Breast cancer-specific survival was examined using cumulative mortality curves and Cox proportional hazards regression models. RESULTS: Of the 27 850 eligible women, 288 (1.03%) identified as Aboriginal. The Aboriginal women were younger and more likely to have advanced spread of disease when diagnosed than non-Aboriginal women. Aboriginal women were less likely than non-Aboriginal women to receive surgical treatment (odds ratio 0.59, 95% confidence interval (CI) 0.42-0.86). The five-year crude breast cancer-specific mortality was 6.1% higher for Aboriginal women (17.7%, 95% CI 12.9-23.2) compared with non-Aboriginal women (11.6%, 95% CI 11.2-12.0). After accounting for differences in age at diagnosis, year of diagnosis, spread of disease and surgical treatment received the risk of death from breast cancer was 39% higher in Aboriginal women (HR 1.39, 95% CI 1.01-1.86). Finally after also accounting for differences in comorbidities, socioeconomic disadvantage and place of residence the hazard ratio was reduced to 1.30 (95% CI 0.94-1.75). CONCLUSION: Preventing comorbidities and increasing rates of surgical treatment may increase breast cancer survival for NSW Aboriginal women
Programme: Health Services Research
Division: Cancer Research Division
Funding Body: The Aboriginal Patterns of Cancer Care Project (APOCC) was funded by a National Health and Medical Research Council Health Services Research grant (Application Ref: 440202).
DOI: 1471-2407-14-163
Appears in Collections:Research Articles

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