Survival from breast cancer: an analysis of Australian data by surgeon case load, treatment centre location, and health insurance status.
Aust Health Rev
; 36(3): 342-8, 2012 Aug.
Article
en En
| MEDLINE
| ID: mdl-22935129
ABSTRACT
OBJECTIVE:
Early invasive breast cancer data from the Australian National Breast Cancer Audit were used to compare case fatality by surgeon case load, treatment centre location and health insurance status.METHOD:
Deaths were traced to 31 December 2007, for cancers diagnosed in 1998-2005. Risk of breast cancer death was compared using Cox proportional hazards regression.RESULTS:
When adjustment was made for age and clinical risk factors (i) the relative risk of breast cancer death (95% confidence limit) was lower when surgeons' annual case loads exceeded 20 cases, at 0.87 (0.76, 0.995) for 21-100 cases and 0.83 (0.72, 0.97) for higher case loads. These relative risks were not statistically significant when also adjusting for treatment centre location (P ≥ 0.15); and (ii) compared with major city centres, inner regional centres had a relative risk of 1.32 (1.18, 1.48), but the risk was not elevated for more remote sites at 0.95 (0.74, 1.22). Risk of death was not related to private insurance status.CONCLUSION:
Higher breast cancer mortality in patients treated in inner regional than major city centres and in those treated by surgeons with lower case loads requires further study.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Ubicación de la Práctica Profesional
/
Cirugía General
/
Neoplasias de la Mama
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Sobrevivientes
/
Cobertura del Seguro
/
Seguro de Salud
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
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Adult
/
Aged
/
Aged80
/
Child
/
Female
/
Humans
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Middle aged
País/Región como asunto:
Oceania
Idioma:
En
Revista:
Aust Health Rev
Año:
2012
Tipo del documento:
Article
País de afiliación:
Australia