Influence of geographic access and socioeconomic characteristics on breast cancer outcomes: A systematic review

Benoit Conti (), Audrey Bochaton (), Hélène Charreire (), Hélène Bonsang-Kitzis, Caroline Desprès, Sandrine Baffert () and Charlotte Ngo ()
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Benoit Conti: LVMT - Laboratoire Ville, Mobilité, Transport - ENPC - École nationale des ponts et chaussées - Université Gustave Eiffel
Audrey Bochaton: LADYSS - Laboratoire Dynamiques Sociales et Recomposition des Espaces - UP1 - Université Paris 1 Panthéon-Sorbonne - UP8 - Université Paris 8 Vincennes-Saint-Denis - UPN - Université Paris Nanterre - CNRS - Centre National de la Recherche Scientifique - UPCité - Université Paris Cité
Hélène Charreire: EREN [CRESS - U1153 / UMR_A 1125] - Nutritional Epidemiology Research Team | Equipe de Recherche en Epidémiologie Nutritionnelle - CNAM - Conservatoire National des Arts et Métiers [CNAM] - Université Sorbonne Paris Nord - CRESS (U1153 / UMR_A 1125) - Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques - USPC - Université Sorbonne Paris Cité - INSERM - Institut National de la Santé et de la Recherche Médicale - UPCité - Université Paris Cité - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, LAB'URBA - LAB'URBA - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12 - Université Gustave Eiffel
Hélène Bonsang-Kitzis: Hôpital privé des Peupliers (Paris)
Caroline Desprès: CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers - EPHE - École Pratique des Hautes Études - PSL - Université Paris Sciences et Lettres - INSERM - Institut National de la Santé et de la Recherche Médicale - SU - Sorbonne Université - UPCité - Université Paris Cité
Sandrine Baffert: CEMKA
Charlotte Ngo: Hôpital privé des Peupliers (Paris), CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers - EPHE - École Pratique des Hautes Études - PSL - Université Paris Sciences et Lettres - INSERM - Institut National de la Santé et de la Recherche Médicale - SU - Sorbonne Université - UPCité - Université Paris Cité

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Abstract: Socioeconomic and geographical inequalities in breast cancer mortality have been widely described in European countries and the United States. To investigate the combined effects of geographic access and socioeconomic characteristics on breast cancer outcomes, a systematic review was conducted exploring the relationships between: (i) geographic access to healthcare facilities (oncology services, mammography screening), defined as travel time and/or travel distance; (ii) breast cancer-related outcomes (mammography screening, stage of cancer at diagnosis, type of treatment and rate of mortality); (iii) socioeconomic status (SES) at individuals and residential context levels. In total, n = 25 studies (29 relationships tested) were included in our systematic review. The four main results are: The statistical significance of the relationship between geographic access and breast cancer-related outcomes is heterogeneous: 15 were identified as significant and 14 as non-significant. Women with better geographic access to healthcare facilities had a statistically significant fewer mastectomy (n = 4/6) than women with poorer geographic access. The relationship with the stage of the cancer is more balanced (n = 8/17) and the relationship with cancer screening rate is not observed (n = 1/4). The type of measures of geographic access (distance, time or geographical capacity) does not seem to have any influence on the results. For example, studies which compared two different measures (travel distance and travel time) of geographic access obtained similar results. The relationship between SES characteristics and breast cancer-related outcomes is significant for several variables: at individual level, age and health insurance status; at contextual level, poverty rate and deprivation index. Of the 25 papers included in the review, the large majority (n = 24) tested the independent effect of geographic access. Only one study explored the combined effect of geographic access to breast cancer facilities and SES characteristics by developing stratified models.

Date: 2022
New Economics Papers: this item is included in nep-hea
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Published in PLoS ONE, 2022, 17 (7), pp.e0271319. ⟨10.1371/journal.pone.0271319⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-03730234

DOI: 10.1371/journal.pone.0271319

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