Geographic variation in the intended choice of adjuvant treatments for women diagnosed with screen-detected breast cancer in Queensland

Although early diagnosis and improved treatment can reduce breast cancer mortality, there still appears to be a geographic differential in patient outcomes. This study aims to determine and quantify spatial inequalities in intended adjuvant (radio-, chemo- and hormonal) therapy usage among women wit...

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Bibliographic Details
Published in:BMC public health 2015-12, Vol.15 (1), p.1204-1204, Article 1204
Main Authors: Hsieh, Jeff Ching-Fu, Cramb, Susanna M, McGree, James M, Dunn, Nathan A M, Baade, Peter D, Mengersen, Kerrie L
Format: Article
Language:English
Subjects:
Adjuvant treatment
Adjuvants, Immunologic
Adult
Aged
Aged, 80 and over
Analysis
Australia
Bayes Theorem
Breast cancer
Breast Neoplasms - diagnosis
Breast Neoplasms - therapy
Cancer
Choice Behavior
Diagnosis
Early Detection of Cancer
Female
Health aspects
Health Services Accessibility
Hormones - therapeutic use
Humans
Intention
Mammography
Medical research
Medicine, Experimental
Middle Aged
Mortality
Public health
Queensland
Radiotherapy
Radiotherapy, Adjuvant
Socioeconomic Factors
Women
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Summary:Although early diagnosis and improved treatment can reduce breast cancer mortality, there still appears to be a geographic differential in patient outcomes. This study aims to determine and quantify spatial inequalities in intended adjuvant (radio-, chemo- and hormonal) therapy usage among women with screen-detected breast cancer in Queensland, Australia. Linked population-based datasets from BreastScreen Queensland and the Queensland Cancer Registry during 1997-2008 for women aged 40-89 years were used. We adopted a Bayesian shared spatial component model to evaluate the relative intended use of each adjuvant therapy across 478 areas as well as common spatial patterns between treatments. Women living closer to a cancer treatment facility were more likely to intend to use adjuvant therapy. This was particularly marked for radiotherapy when travel time to the closest radiation facility was 4 + h (OR =0.41, 95 % CrI: [0.23, 0.74]) compared to
ISSN:1471-2458
1471-2458
DOI:10.1186/s12889-015-2527-2