Geographical Inequalities in Surgical Treatment for Localized Female Breast Cancer, Queensland, Australia 1997–2011: Improvements over Time but Inequalities Remain

Peter D. Baade, Paramita Dasgupta, Philippa H. Youl, Christopher Pyke and Joanne F. Aitken
Additional contact information
Peter D. Baade: Cancer Council Queensland, P.O. Box 201, Spring Hill, QLD 4004, Australia
Paramita Dasgupta: Cancer Council Queensland, P.O. Box 201, Spring Hill, QLD 4004, Australia
Philippa H. Youl: Cancer Council Queensland, P.O. Box 201, Spring Hill, QLD 4004, Australia
Christopher Pyke: Mater Medical Centre, 293 Vulture Street, South Brisbane, QLD 4101, Australia
Joanne F. Aitken: Cancer Council Queensland, P.O. Box 201, Spring Hill, QLD 4004, Australia

IJERPH, 2016, vol. 13, issue 7, 1-14

Abstract: The uptake of breast conserving surgery (BCS) for early stage breast cancer varies by where women live. We investigate whether these geographical patterns have changed over time using population-based data linkage between cancer registry records and hospital inpatient episodes. The study cohort consisted of 11,631 women aged 20 years and over diagnosed with a single primary invasive localised breast cancer between 1997 and 2011 in Queensland, Australia who underwent either BCS ( n = 9223, 79%) or mastectomy ( n = 2408, 21%). After adjustment for socio-demographic and clinical factors, compared to women living in very high accessibility areas, women in high (Odds Ratio (OR) 0.58 (95% confidence intervals (CI) 0.49, 0.69)), low (OR 0.47 (0.41, 0.54)) and very low (OR 0.44 (0.34, 0.56)) accessibility areas had lower odds of having BCS, while the odds for women from middle (OR 0.81 (0.69, 0.94)) and most disadvantaged (OR 0.87 (0.71, 0.98)) areas was significantly lower than women living in affluent areas. The association between accessibility and the type of surgery reduced over time (interaction p = 0.028) but not for area disadvantage (interaction p = 0.209). In making informed decisions about surgical treatment, it is crucial that any geographical-related barriers to implementing their preferred treatment are minimised.

Keywords: breast cancer; geography; inequalities; mastectomy; breast conserving surgery; socioeconomic (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2016
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