Titre
Socioeconomic and demographic disparities in breast cancer stage at presentation and survival: A Swiss population-based study.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Feller, A.
Auteure/Auteur
Schmidlin, K.
Auteure/Auteur
Bordoni, A.
Auteure/Auteur
Bouchardy, C.
Auteure/Auteur
Bulliard, J.L.
Auteure/Auteur
Camey, B.
Auteure/Auteur
Konzelmann, I.
Auteure/Auteur
Maspoli, M.
Auteure/Auteur
Wanner, M.
Auteure/Auteur
Clough-Gorr, K.M.
Auteure/Auteur
Groupes de travail
SNC and the NICER workinggroup
Liens vers les personnes
Liens vers les unités
ISSN
1097-0215
Statut éditorial
Publié
Date de publication
2017-10-15
Volume
141
Numéro
8
Première page
1529
Dernière page/numéro d’article
1539
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
We explored socioeconomic and demographic disparities in breast cancer (BC) stage at presentation and survival in a Swiss population-based sample of female BC patients linked to the census-based Swiss National Cohort. Tumor stage was classified according to Surveillance, Epidemiology and End Results Program summary stage (in situ/localized/regional/distant). We used highest education level attained to estimate SEP (low/middle/high). Further demographic characteristics of interest were age at presentation (30-49/50-69/70-84 years), living in a canton with organized screening (yes/no), urbanity of residence (urban/peri-urban/rural), civil status (single/married/widowed/divorced) and nationality (Swiss/non-Swiss). We used ordered logistic regression models to analyze factors associated with BC stage at presentation and competing risk regression models for factors associated with survival. Odds of later-stage BC were significantly increased for low SEP women (odds ratio 1.19, 95%CI 1.06-1.34) compared to women of high SEP. Further, women living in a canton without organized screening program, women diagnosed outside the targeted screening age and single/widowed/divorced women were more often diagnosed at later stages. Women of low SEP experienced an increased risk of dying from BC (sub-hazard ratio 1.22, 95%CI 1.05-1.43) compared to women of high SEP. Notably, these survival inequalities could not be explained by socioeconomic differences in stage at presentation and/or other sociodemographic factors. It is concerning that these social gradients have been observed in a country with universal health insurance coverage, high health expenditures and one of the highest life expectancies in the world.
PID Serval
serval:BIB_0AFE12659540
PMID
Date de création
2017-07-06T15:30:38.208Z
Date de création dans IRIS
2025-05-20T14:44:16Z
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Nom
PostPrint28657175.pdf
Version du manuscrit
postprint
Taille
909.32 KB
Format
Adobe PDF
PID Serval
serval:BIB_0AFE12659540.P001
URN
urn:nbn:ch:serval-BIB_0AFE126595409
Somme de contrôle
(MD5):17f5ff04b583c41d3c536e9cbe13af8c