ArticleOncotarget2016
What might explain deprivation-specific differences in the excess hazard of breast cancer death amongst screen-detected women? Analysis of patients diagnosed in the West Midlands region of England from 1989 to 2011.
Article in Oncotarget, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors Explaining Socio-Economic Inequalities in Cancer Survival: A Systematic Review.Cancer control : journal of the Moffitt Cancer CenterPooled it
- Estimating causal effects in the presence of competing events using regression standardisation with the Stata command standsurv.BMC medical research methodology · 2022Article
- Socioeconomic status and its relation with breast cancer recurrence and survival in young women in the Netherlands.Cancer epidemiology · 2022Article
- Prediction of cancer survival for cohorts of patients most recently diagnosed using multi-model inference.Statistical methods in medical research · 2020Article
- Estimating the impact of a cancer diagnosis on life expectancy by socio-economic group for a range of cancer types in England.British journal of cancer · 2017Article
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Authors and funding
3 authors.
Funding
Abstract
backgroundBreast cancer survival is higher in less deprived women, even amongst women whose tumor was screen-detected, but reasons behind this have not been comprehensively investigated.
methodsThe excess hazard of breast cancer death in 20,265 women diagnosed with breast cancer, followed up to 2012, was estimated for screen-detected and non-screen-detected women, comparing more deprived to less deprived women using flexible parametric models. Models were adjusted for individual and tumor factors, treatment received and comorbidity. For screen-detected women, estimates were also corrected for lead-time and overdiagnosis.
resultsThe excess hazard ratio (EHR) of breast cancer death in the most deprived group, adjusted only for age and year of diagnosis, was twice that of the least deprived among screen-detected women (EHR=2.12, 95%CI 1.48-2.76) and 64% higher among non-screen-detected women (EHR=1.64, 95%CI 1.41-1.87). Adjustment for stage at diagnosis lowered these estimates by 25%. Further adjustment had little extra impact. In the final models, the excess hazard for the most deprived women was 54% higher (EHR=1.54, 95%CI 1.10-1.98) among screen-detected women and 39% higher (EHR=1.39, 95%CI 1.20-1.59) among non-screen-detected women.
conclusionA persistent socio-economic gradient in breast cancer-related death exists in this cohort, even for screen-detected women. The impact of differential lifestyles, management and treatment warrant further investigation.
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