Small but significant socioeconomic inequalities in axillary staging and treatment of breast cancer in the Netherlands.
Br J Cancer
; 107(1): 12-7, 2012 Jun 26.
Article
em En
| MEDLINE
| ID: mdl-22596236
ABSTRACT
BACKGROUND:
The use of sentinel node biopsy (SNB), lymph node dissection, breast-conserving surgery, radiotherapy, chemotherapy and hormonal treatment for breast cancer was evaluated in relation to socioeconomic status (SES) in the Netherlands, where access to care was assumed to be equal.METHODS:
Female breast cancer patients diagnosed between 1994 and 2008 were selected from the nationwide population-based Netherlands Cancer Registry (N=176 505). Socioeconomic status was assessed based on income, employment and education at postal code level. Multivariable models included age, year of diagnosis and stage.RESULTS:
Sentinal node biopsy was less often applied in high-SES patients (multivariable analyses, ≤ 49 years odds ratio (OR) 0.70 (95% CI 0.56-0.89); 50-75 years 0.85 (0.73-0.99)). Additionally, lymph node dissection was less common in low-SES patients aged ≥ 76 years (OR 1.34 (0.95-1.89)). Socioeconomic status-related differences in treatment were only significant in the age group 50-75 years. High-SES women with stage T1-2 were more likely to undergo breast-conserving surgery (+radiotherapy) (OR 1.15 (1.09-1.22) and OR 1.16 (1.09-1.22), respectively). Chemotherapy use among node-positive patients was higher in the high-SES group, but was not significant in multivariable analysis. Hormonal therapy was not related to SES.CONCLUSION:
Small but significant differences were observed in the use of SNB, lymph node dissection and breast-conserving surgery according to SES in Dutch breast cancer patients despite assumed equal access to health care.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Classe Social
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Neoplasias da Mama
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Disparidades em Assistência à Saúde
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Estadiamento de Neoplasias
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Middle aged
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article