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Borghi G, Delacôte C, Delacour-Billon S, Ayrault-Piault S, Dabakuyo-Yonli TS, Delafosse P, Woronoff AS, Trétarre B, Molinié F, Cowppli-Bony A. Socioeconomic Deprivation and Invasive Breast Cancer Incidence by Stage at Diagnosis: A Possible Explanation to the Breast Cancer Social Paradox. Cancers (Basel) 2024; 16:1701. [PMID: 38730653 PMCID: PMC11083525 DOI: 10.3390/cancers16091701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
In this study, we assessed the influence of area-based socioeconomic deprivation on the incidence of invasive breast cancer (BC) in France, according to stage at diagnosis. All women from six mainland French departments, aged 15+ years, and diagnosed with a primary invasive breast carcinoma between 2008 and 2015 were included (n = 33,298). Area-based socioeconomic deprivation was determined using the French version of the European Deprivation Index. Age-standardized incidence rates (ASIR) by socioeconomic deprivation and stage at diagnosis were compared estimating incidence rate ratios (IRRs) adjusted for age at diagnosis and rurality of residence. Compared to the most affluent areas, significantly lower IRRs were found in the most deprived areas for all-stages (0.85, 95% CI 0.81-0.89), stage I (0.77, 95% CI 0.72-0.82), and stage II (0.84, 95% CI 0.78-0.90). On the contrary, for stages III-IV, significantly higher IRRs (1.18, 95% CI 1.08-1.29) were found in the most deprived areas. These findings provide a possible explanation to similar or higher mortality rates, despite overall lower incidence rates, observed in women living in more deprived areas when compared to their affluent counterparts. Socioeconomic inequalities in access to healthcare services, including screening, could be plausible explanations for this phenomenon, underlying the need for further research.
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Affiliation(s)
- Giulio Borghi
- Loire-Atlantique/Vendée Cancer Registry, 44093 Nantes, France
| | - Claire Delacôte
- Loire-Atlantique/Vendée Cancer Registry, 44093 Nantes, France
- SIRIC ILIAD INCa-DGOS-INSERM-ITMO Cancer_18011, CHU Nantes, 44000 Nantes, France
| | - Solenne Delacour-Billon
- Loire-Atlantique/Vendée Cancer Registry, 44093 Nantes, France
- SIRIC ILIAD INCa-DGOS-INSERM-ITMO Cancer_18011, CHU Nantes, 44000 Nantes, France
- French Network of Cancer Registries (FRANCIM), 31000 Toulouse, France
| | - Stéphanie Ayrault-Piault
- Loire-Atlantique/Vendée Cancer Registry, 44093 Nantes, France
- SIRIC ILIAD INCa-DGOS-INSERM-ITMO Cancer_18011, CHU Nantes, 44000 Nantes, France
- French Network of Cancer Registries (FRANCIM), 31000 Toulouse, France
| | - Tienhan Sandrine Dabakuyo-Yonli
- French Network of Cancer Registries (FRANCIM), 31000 Toulouse, France
- Côte d’Or Breast and Gynaecologic Cancer Registry, INSERM U1231, 21000 Dijon, France
| | - Patricia Delafosse
- French Network of Cancer Registries (FRANCIM), 31000 Toulouse, France
- Isère Cancer Registry, 38000 Grenoble, France
| | - Anne-Sophie Woronoff
- French Network of Cancer Registries (FRANCIM), 31000 Toulouse, France
- Doubs Cancer Registry, 25000 Besançon, France
| | - Brigitte Trétarre
- French Network of Cancer Registries (FRANCIM), 31000 Toulouse, France
- Hérault Cancer Registry, 34000 Montpellier, France
- EQUITY Research Team (Certified by the French League Against Cancer), CERPOP, UMR 1295, Université Toulouse III Paul Sabatier, 31000 Toulouse, France
| | - Florence Molinié
- Loire-Atlantique/Vendée Cancer Registry, 44093 Nantes, France
- SIRIC ILIAD INCa-DGOS-INSERM-ITMO Cancer_18011, CHU Nantes, 44000 Nantes, France
- French Network of Cancer Registries (FRANCIM), 31000 Toulouse, France
- EQUITY Research Team (Certified by the French League Against Cancer), CERPOP, UMR 1295, Université Toulouse III Paul Sabatier, 31000 Toulouse, France
| | - Anne Cowppli-Bony
- Loire-Atlantique/Vendée Cancer Registry, 44093 Nantes, France
- SIRIC ILIAD INCa-DGOS-INSERM-ITMO Cancer_18011, CHU Nantes, 44000 Nantes, France
- French Network of Cancer Registries (FRANCIM), 31000 Toulouse, France
- EQUITY Research Team (Certified by the French League Against Cancer), CERPOP, UMR 1295, Université Toulouse III Paul Sabatier, 31000 Toulouse, France
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Larsen C, Kirchhoff KS, Saltbæk L, Thygesen LC, Karlsen RV, Svendsen MN, Høeg BL, Horsbøl TA, Bidstrup PE, Christensen HG, Johansen C, Dalton SO. The association between education and fear of recurrence among breast cancer patients in follow-up - and the mediating effect of self-efficacy. Acta Oncol 2023; 62:714-718. [PMID: 37039679 DOI: 10.1080/0284186x.2023.2197122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 03/27/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Major restructuring of surveillance after breast cancer treatment with less follow-up consultations may result in insecurity and fear of recurrence (FCR) among the less resourceful breast cancer patients. We investigate the association between breast cancer patients' education and FCR and if self-efficacy mediates the associations between education and FCR. MATERIAL AND METHODS A questionnaire survey was conducted from 2017 to 2019, among 1773 breast cancer patients shortly after having their follow-up switched from regular outpatient visits with an oncologist to either nurse-led or patient-initiated follow-up, with a subsequent questionnaire after 12 months. Data on disease and treatment characteristics were extracted from medical records and the Danish Breast Cancer Group Database. Logistic regression analyses were used to examine the association between education and FCR. Separate analyses were conducted for patients ≤ and >5 years since diagnosis and all models were adjusted for age and cohabitation status. To explore potential mediation by self-efficacy, we conducted regression analyses on education and FCR further adjusting for self-efficacy. RESULTS The participation rate was 57%, and after the exclusion of patients due to missing data, 917 were included in analyses. Patients with long education had significantly less FCR compared to patients with short education (OR (95% CI) 0.71 (0.51;0,99)). When separated by time since diagnosis, there was no association among patients >5 years since diagnosis while the OR was 0.51 (95% CI, 0.30;0.85) for patients ≤5 years since diagnosis. Further adjusting for self-efficacy among patients <5 years since diagnosis resulted in an OR of 0.56 (95% CI, 0.33;0.95) among patients with long compared to short education. CONCLUSION Up to 5 years after diagnosis, breast cancer patients with long education are less likely to experience FCR than patients with short education. Self-efficacy mediated only a very small part of this association, indicating that other factors play a role in socioeconomic differences in FCR among breast cancer patients.
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Affiliation(s)
- Cecilie Larsen
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Surgery and Center of Surgical Science, Zealand University Hospital, Køge, Denmark
| | - Kirstine S Kirchhoff
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Emergency Department, Zealand University Hospital, Køge, Denmark
| | - Lena Saltbæk
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark
| | - Lau C Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Randi V Karlsen
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mads N Svendsen
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark
| | - Beverley L Høeg
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Trine A Horsbøl
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Pernille E Bidstrup
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Helle G Christensen
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark
| | - Christoffer Johansen
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- CASTLE, Danish Cancer Society Research Center for Late Effects after Cancer, Finsen Center, Rigshospitalet, Copenhagen, Denmark
| | - Susanne O Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark
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Frelaut M, Aupomerol M, Degousée L, Scotté F. [The place of support care]. SOINS. GERONTOLOGIE 2022; 27:21-29. [PMID: 36280368 DOI: 10.1016/j.sger.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Supportive care, in the context of breast cancer in the elderly, is part of standard oncogeriatric care. Nevertheless, the multidisciplinary reinforcement of the different transversal teams can support the global approach, that is essential to the quality of care and the life course. Evaluation is the basis of this management. As a result of this evaluation, the approach to sexual health is a novelty that is often insufficiently considered with elderly patients suffering from breast malignancy.
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Affiliation(s)
| | - Marion Aupomerol
- Service de pathologie mammaire et de gynécologie, département de médecine oncologique
| | - Lena Degousée
- Service de pathologie mammaire et de gynécologie, département de médecine oncologique
| | - Florian Scotté
- DIOPP, Gustave-Roussy, 114 rue Édouard-Vaillant, 94805 Villejuif, France.
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Vercelli M, Lillini R, Brunori V, Bianconi F, Stracci F. Effects of deprivation and age on staging of breast, colon, rectum and prostate cancer in Umbria region, Italy: a multilevel approach. Eur J Cancer Prev 2022; 31:85-92. [PMID: 34172669 DOI: 10.1097/cej.0000000000000674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Early diagnosis of breast, colon, rectum and prostate cancers improves health outcomes. Low socioeconomic status (SES) is related to advanced stages at diagnosis; inequalities could explain differences in outcomes by age. The influence of SES, age and residence area on staging was explored in the Umbrian population. METHODS 2001-2010 cases were geo-coded by census tract of residence. Stage distribution or Gleason score were analyzed by multilevel multinomial logistic regression with age and SES as the fixed effects and census tract as the random-effect. RESULTS For breast and colorectal cancers, the screening age class was advantaged. For breast, age effect was modulated by deprivation and census tract. In the elderly, the richest were advantaged, the poorest disadvantaged; issues emerged for the young. For colon, age effect is modulated by census tract in early stages and deprivation in late stages. The elderly were disadvantaged; the young and the deprived had more stages IV. About rectum, age effect was modulated by deprivation in the late stages. The elderly were disadvantaged; the young and the deprived presented more stages IV. For prostate, age effect was modulated by deprivation and census tract. The intermediate age class was advantaged, the elderly disadvantaged. CONCLUSION Age was not always the determinant of a delayed staging when SES was considered. For breast and colorectal cancers, issues of delayed diagnosis emerged in the young. If the care center was near the residence, the census tract modified the stage at diagnosis. These results are useful to reduce SES barriers by specific programs adapted to the age of the patient and area of residence.
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Affiliation(s)
- Marina Vercelli
- Department of Health Sciences (DISSAL), University of Genoa, Genoa
| | - Roberto Lillini
- Analytical Epidemiology & Health Impact Unit, Fondazione IRCCS "Istituto Nazionale dei Tumori", Milan
| | - Valerio Brunori
- Public Health Section, Department of Experimental Medicine, University of Perugia, Perugia
- Umbrian Population Cancer Registry, Regional Government of Umbria/University of Perugia, Perugia, Italy
| | - Fortunato Bianconi
- Public Health Section, Department of Experimental Medicine, University of Perugia, Perugia
- Umbrian Population Cancer Registry, Regional Government of Umbria/University of Perugia, Perugia, Italy
| | - Fabrizio Stracci
- Public Health Section, Department of Experimental Medicine, University of Perugia, Perugia
- Umbrian Population Cancer Registry, Regional Government of Umbria/University of Perugia, Perugia, Italy
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5
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Poiseuil M, Tron L, Woronoff AS, Trétarre B, Dabakuyo-Yonli TS, Fauvernier M, Roche L, Dejardin O, Molinié F, Launoy G. How do age and social environment affect the dynamics of death hazard and survival in patients with breast or gynecological cancer in France? Int J Cancer 2021; 150:253-262. [PMID: 34520579 DOI: 10.1002/ijc.33803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/22/2021] [Accepted: 08/04/2021] [Indexed: 11/07/2022]
Abstract
Several studies have investigated the association between net survival (NS) and social inequalities in people with cancer, highlighting a varying influence of deprivation depending on the type of cancer studied. However, few of these studies have accounted for the effect of social inequalities over the follow-up period, and/or according to the age of the patients. Thus, using recent and more relevant statistical models, we investigated the effect of social environment on NS in women with breast or gynecological cancer in France. The data were derived from population-based cancer registries, and women diagnosed with breast or gynecological cancer between 2006 and 2009 were included. We used the European deprivation index (EDI), an aggregated index, to define the social environment of the women included. Multidimensional penalized splines were used to model excess mortality hazard. We observed a significant effect of the EDI on NS in women with breast cancer throughout the follow-up period, and especially at 1.5 years of follow-up in women with cervical cancer. Regarding corpus uteri and ovarian cancer patients, the effect of deprivation on NS was less pronounced. These results highlight the impact of social environment on NS in women with breast or gynecological cancer in France thanks to a relevant statistical approach, and identify the follow-up periods during which the social environment may have a particular influence. These findings could help investigate targeted actions for each cancer type, particularly in the most deprived areas, at the time of diagnosis and during follow-up.
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Affiliation(s)
- Marie Poiseuil
- Univ. Bordeaux, Gironde General Cancer Registry, Bordeaux, France.,Inserm, Bordeaux Population Health, Research Center U1219, Team EPICENE, Bordeaux, France
| | - Laure Tron
- 'ANTICIPE' U1086 INSERM-UCN, Normandie Université UNICAEN, Centre François Baclesse, Caen, France
| | - Anne-Sophie Woronoff
- Doubs Cancer Registry, Besançon University Hospital, Besançon, France.,Research Unit EA3181, University of Burgundy Franche-Comté, Besançon, France.,French Network of Cancer Registries (FRANCIM), Toulouse, France
| | - Brigitte Trétarre
- French Network of Cancer Registries (FRANCIM), Toulouse, France.,Hérault Cancer Registry, Montpellier, France
| | - Tienhan Sandrine Dabakuyo-Yonli
- French Network of Cancer Registries (FRANCIM), Toulouse, France.,Breast and Gynecologic Cancer Registry of Côte d'Or, Georges Francois Leclerc Comprehensive Cancer Centre, Dijon, France.,Epidemiology and Quality of Life Research Unit, INSERM U1231, Dijon, France
| | - Mathieu Fauvernier
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique - Bioinformatique, Lyon, France.,Lyon University, Lyon 1 University, CNRS, UMR 5558, Biometrics and Evolutionary Biology Laboratory, Biostatistics and Health Team, Villeurbanne, France
| | - Laurent Roche
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique - Bioinformatique, Lyon, France.,Lyon University, Lyon 1 University, CNRS, UMR 5558, Biometrics and Evolutionary Biology Laboratory, Biostatistics and Health Team, Villeurbanne, France
| | - Olivier Dejardin
- 'ANTICIPE' U1086 INSERM-UCN, Normandie Université UNICAEN, Centre François Baclesse, Caen, France.,Research Department, Caen University Hospital Centre, Caen, France
| | - Florence Molinié
- French Network of Cancer Registries (FRANCIM), Toulouse, France.,Loire-Atlantique/Vendée Cancer Registry, Nantes, France.,SIRIC-ILIAD, INCA-DGOS-Inserm_12558, CHU Nantes, Nantes, France
| | - Guy Launoy
- 'ANTICIPE' U1086 INSERM-UCN, Normandie Université UNICAEN, Centre François Baclesse, Caen, France.,French Network of Cancer Registries (FRANCIM), Toulouse, France.,Research Department, Caen University Hospital Centre, Caen, France
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6
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Brazee RL, Nugent BD, Sereika SM, Rosenzweig M. The Quality of End-of-Life Care for Women Deceased From Metastatic Breast Cancer. J Hosp Palliat Nurs 2021; 23:238-247. [PMID: 33782263 DOI: 10.1097/njh.0000000000000746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Metastatic breast cancer (MBC) carries unique disease burdens with potential for poor-quality end-of-life (EOL) care. It is the purpose of this article to explore the association of poor-quality EOL care indicators according to key tumor, demographic, social, and clinical factors. End-of-life quality indicators were based on Emanuel and Emanuel's good death model in conjunction with Earle et al (2003). A single-institution retrospective chart review of women deceased from MBC between November 2016 and November 2019 with double-verification chart review was completed. Data were analyzed with descriptive, correlative, and comparative statistics. Total sample was N = 167 women, with 14.4% (n = 24) Black and 85.6% (n = 143) White. Mean (SD) age was 55.3 (11.73) years. Overall, MBC survival was 3.12 years (SD, 3.31): White women, 41.2 months (3.4 years), and Black women, 19 months (1.6 years). A total of 64.1% (n = 107) experienced 1 or more indicators of poor-quality EOL care. Patients more likely to experience poor-quality EOL care were older (P = .03), estrogen negative (P = .08), human epidermal growth factor receptor 2 negative (P = .07), from more deprived neighborhoods (P = .02), married (P = .05), and with physical (P = .001) and mental (P = .002) comorbidities. Understanding sociodemographic and clinical factors associated with poor EOL MBC care may be useful for proactive patient navigation.
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Rosskamp M, Verbeeck J, Gadeyne S, Verdoodt F, De Schutter H. Socio-Economic Position, Cancer Incidence and Stage at Diagnosis: A Nationwide Cohort Study in Belgium. Cancers (Basel) 2021; 13:cancers13050933. [PMID: 33668089 PMCID: PMC7956180 DOI: 10.3390/cancers13050933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Socio-economic position is associated with cancer incidence, but the direction and magnitude of this relationship differs across cancer types, geographical regions, and socio-economic parameters. In this nationwide cohort study, we evaluated the association between different individual-level socio-economic and -demographic factors, cancer incidence, and stage at diagnosis in Belgium. Methods: The 2001 census was linked to the nationwide Belgian Cancer Registry for cancer diagnoses between 2004 and 2013. Socio-economic parameters included education level, household composition, and housing conditions. Incidence rate ratios were assessed through Poisson regression models. Stage-specific analyses were conducted through logistic regression models. Results: Deprived groups showed higher risks for lung cancer and head and neck cancers, whereas an inverse relation was observed for malignant melanoma and female breast cancer. Typically, associations were more pronounced in men than in women. A lower socio-economic position was associated with reduced chances of being diagnosed with known or early stage at diagnosis; the strongest disparities were found for male lung cancer and female breast cancer. Conclusions: This study identified population groups at increased risk of cancer and unknown or advanced stage at diagnosis in Belgium. Further investigation is needed to build a comprehensive picture of socio-economic inequality in cancer incidence.
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Affiliation(s)
- Michael Rosskamp
- Belgian Cancer Registry, Rue Royale 215, B-1210 Brussels, Belgium; (J.V.); (F.V.); (H.D.S.)
- Correspondence: ; Tel.: +32-2-250-1010
| | - Julie Verbeeck
- Belgian Cancer Registry, Rue Royale 215, B-1210 Brussels, Belgium; (J.V.); (F.V.); (H.D.S.)
| | - Sylvie Gadeyne
- Sociology Department, Interface Demography, Vrije Universiteit Brussel, Pleinlaan 5, B-1050 Brussels, Belgium;
| | - Freija Verdoodt
- Belgian Cancer Registry, Rue Royale 215, B-1210 Brussels, Belgium; (J.V.); (F.V.); (H.D.S.)
| | - Harlinde De Schutter
- Belgian Cancer Registry, Rue Royale 215, B-1210 Brussels, Belgium; (J.V.); (F.V.); (H.D.S.)
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Giorgi Rossi P, Djuric O, Navarra S, Rossi A, Di Napoli A, Frova L, Petrelli A. Geographic Inequalities in Breast Cancer in Italy: Trend Analysis of Mortality and Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114165. [PMID: 32545263 PMCID: PMC7312287 DOI: 10.3390/ijerph17114165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/04/2020] [Accepted: 06/09/2020] [Indexed: 12/24/2022]
Abstract
We calculated time trends of standardised mortality rates and risk factors for breast cancer (BC) from 1990 to 2016 for all women resident in Italy. The age-standardised mortality rate in Italy decreased from 4.2 in 1990 to 3.2 (×100,000) in 2016. While participation in organised screening programmes and age-standardised fertility rates decreased in Italy, screening invitation coverage and mammography uptake, the prevalence of women who breastfed and mean age at birth increased. Although southern regions had favourable prevalence of protective risk factors in the 1990s, fertility rates decreased in southern regions and increased in northern regions, which in 2016 had a higher rate (1.28 vs. 1.32 child per woman) and a smaller increase in women who breastfed (+4% vs. +30%). In 2000, mammography screening uptake was lower in southern than in northern and central regions (28% vs. 52%). However, the increase in mammography uptake was higher in southern (203%) than in northern and central Italy (80%), reducing the gap. Participation in mammographic screening programmes decreased in southern Italy (−10%) but increased in the North (6.6%). Geographic differences in mortality and risk factor prevalence is diminishing, with the South losing all of its historical advantage in breast cancer mortality.
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Affiliation(s)
- Paolo Giorgi Rossi
- Servizio di Epidemiologia, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy;
| | - Olivera Djuric
- Servizio di Epidemiologia, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy;
- Center for Environmental, Nutritional and Genetic Epidemiology (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Università 4, 41121 Modena, Italy
- Correspondence: ; Tel.: +39-052-233-5278
| | - Simone Navarra
- National Institute of Statistics (Istat), Viale Liegi 13, 00198 Rome, Italy; (S.N.); (L.F.)
| | - Alessandra Rossi
- National Institute for Health, Migration and Poverty (INMP), Via di San Gallicano, 25/a, 00153 Rome, Italy; (A.R.); (A.D.N.); (A.P.)
| | - Anteo Di Napoli
- National Institute for Health, Migration and Poverty (INMP), Via di San Gallicano, 25/a, 00153 Rome, Italy; (A.R.); (A.D.N.); (A.P.)
| | - Luisa Frova
- National Institute of Statistics (Istat), Viale Liegi 13, 00198 Rome, Italy; (S.N.); (L.F.)
| | - Alessio Petrelli
- National Institute for Health, Migration and Poverty (INMP), Via di San Gallicano, 25/a, 00153 Rome, Italy; (A.R.); (A.D.N.); (A.P.)
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9
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Effect of a national population-based breast cancer screening policy on participation in mammography and stage at breast cancer diagnosis in Taiwan. Health Policy 2020; 124:478-485. [DOI: 10.1016/j.healthpol.2020.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 02/12/2020] [Accepted: 02/14/2020] [Indexed: 12/11/2022]
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10
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Berger E, Delpierre C, Despas F, Bertoli S, Bérard E, Bombarde O, Bories P, Sarry A, Laurent G, Récher C, Lamy S. Are social inequalities in acute myeloid leukemia survival explained by differences in treatment utilization? Results from a French longitudinal observational study among older patients. BMC Cancer 2019; 19:883. [PMID: 31488077 PMCID: PMC6729078 DOI: 10.1186/s12885-019-6093-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/26/2019] [Indexed: 02/07/2023] Open
Abstract
Background Evidences support social inequalities in cancer survival. Studies on hematological malignancies, and more specifically Acute Myeloid Leukemia (AML), are sparser. Our study assessed: 1/ the influence of patients’ socioeconomic position on survival, 2/ the role of treatment in this relationship, and 3/ the influence of patients’ socioeconomic position on treatment utilization. Methods This prospective multicenter study includes all patients aged 60 and older, newly diagnosed with AML, excluding promyelocytic subtypes, between 1st January 2009 to 31st December 2014 in the South-West of France. Data came from medical files. Patients’ socioeconomic position was measured by an ecological deprivation index, the European Deprivation Index. We studied first, patients’ socioeconomic position influence on overall survival (n = 592), second, on the use of intensive chemotherapy (n = 592), and third, on the use of low intensive treatment versus best supportive care among patients judged unfit for intensive chemotherapy (n = 405). Results We found an influence of patients’ socioeconomic position on survival (highest versus lowest position HRQ5: 1.39 [1.05;1.87] that was downsized to become no more significant after adjustment for AML ontogeny (HRQ5: 1.31[0.97;1.76] and cytogenetic prognosis HRQ5: 1.30[0.97;1.75]). The treatment was strongly associated with survival. A lower proportion of intensive chemotherapy was observed among patients with lowest socioeconomic position (ORQ5: 0.41[0.19;0.90]) which did not persist after adjustment for AML ontogeny (ORQ5: 0.59[0.25;1.40]). No such influence of patients’ socioeconomic position was found on the treatment allocation among patients judged unfit for intensive chemotherapy. Conclusions Finally, these results suggest an indirect influence of patients’ socioeconomic position on survival through AML initial presentation. Electronic supplementary material The online version of this article (10.1186/s12885-019-6093-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eloïse Berger
- LEASP, UMR 1027, Equipe labellisée Ligue Nationale Contre le Cancer, Faculté de médecine de Purpan, Inserm-Université Toulouse III Paul Sabatier, 37 allées Jules Guesde, 31000, Toulouse, France.
| | - Cyrille Delpierre
- LEASP, UMR 1027, Equipe labellisée Ligue Nationale Contre le Cancer, Faculté de médecine de Purpan, Inserm-Université Toulouse III Paul Sabatier, 37 allées Jules Guesde, 31000, Toulouse, France
| | - Fabien Despas
- LEASP, UMR 1027, Equipe labellisée Ligue Nationale Contre le Cancer, Faculté de médecine de Purpan, Inserm-Université Toulouse III Paul Sabatier, 37 allées Jules Guesde, 31000, Toulouse, France.,Service de Pharmacologie Clinique, CHU de Toulouse, Toulouse, France
| | - Sarah Bertoli
- Service d'hématologie, Institut Universitaire du Cancer de Toulouse - Oncopôle, CHU de Toulouse, Toulouse, France
| | - Emilie Bérard
- LEASP, UMR 1027, Equipe labellisée Ligue Nationale Contre le Cancer, Faculté de médecine de Purpan, Inserm-Université Toulouse III Paul Sabatier, 37 allées Jules Guesde, 31000, Toulouse, France.,Service d'Epidemiologie, CHU de Toulouse, Toulouse, France
| | - Oriane Bombarde
- Service de Pharmacologie Clinique, CHU de Toulouse, Toulouse, France
| | - Pierre Bories
- Service d'hématologie, Institut Universitaire du Cancer de Toulouse - Oncopôle, CHU de Toulouse, Toulouse, France.,Réseau régional de cancérologie Onco-Occitanie, Institut Universitaire du Cancer de Toulouse Oncopôle, Toulouse, France
| | - Audrey Sarry
- Service d'hématologie, Institut Universitaire du Cancer de Toulouse - Oncopôle, CHU de Toulouse, Toulouse, France
| | - Guy Laurent
- LEASP, UMR 1027, Equipe labellisée Ligue Nationale Contre le Cancer, Faculté de médecine de Purpan, Inserm-Université Toulouse III Paul Sabatier, 37 allées Jules Guesde, 31000, Toulouse, France
| | - Christian Récher
- Service d'hématologie, Institut Universitaire du Cancer de Toulouse - Oncopôle, CHU de Toulouse, Toulouse, France.,Centre de Recherche en Cancérologie de Toulouse UMR 1037 Inserm / ERL5294 CNRS, University of Toulouse 3 Paul Sabatier, Toulouse, France
| | - Sébastien Lamy
- LEASP, UMR 1027, Equipe labellisée Ligue Nationale Contre le Cancer, Faculté de médecine de Purpan, Inserm-Université Toulouse III Paul Sabatier, 37 allées Jules Guesde, 31000, Toulouse, France.,Service de Pharmacologie Clinique, CHU de Toulouse, Toulouse, France
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11
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Fritz UAA, Pfaff H, Roth L, Swora M, Groß SE. [Influence of Sociodemographic Factors on Type of and Stage at Diagnosis in Breast Cancer]. DAS GESUNDHEITSWESEN 2019; 82:684-690. [PMID: 31311059 DOI: 10.1055/a-0938-4111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study examines the influence of sociodemographic factors on the type of and stage at diagnosis in breast cancer in Germany. METHOD As part of the certification of the breast cancer centers by the German Cancer Society (DGK), the Institute of Medical Sociology, Health Services and Rehabilitation Science (IMVR) conducted nationwide post-stationary postal patient surveys (n=852). The influence of sociodemographic factors on the type of diagnosis and on the stage at diagnosis were each analyzed using a multinomial logistic regression. RESULTS 45.5% palpated the tumor by themselves, 33.4% were diagnosed by mammography screening and 16.6% by gynecological check-up. Being diagnosed by screening was associated with an early stage cancer. Furthermore, breast cancer patients without private health insurance or with a low educational level were less likely to be diagnosed by a gynecological check-up. Patients within screening age (50-69) had higher odds for an early stage breast cancer. Patients with a low educational level had lower odds for an early stage breast cancer. CONCLUSION Fifty percent of the breast cancer patients were not diagnosed by screening. Mammography screening appears to be more sensitive in detecting early stage cancer, since we found an association between diagnosis by screening and an early stage cancer. Age outside of the screening range and a low educational level might be risk factors for an advanced stage breast cancer. High screening rates, especially for these risk groups, seem to be important for early detection of breast cancer.
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Affiliation(s)
- Ulrike Annette Anja Fritz
- Medizinische Fakultät, Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft (IMVR) der Humanwissenschaftlichen Fakultät und der Medizinischen Fakultät der Universität zu Köln
| | - Holger Pfaff
- Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft (IMVR) der Humanwissenschaftlichen Fakultät und der Medizinischen Fakultät der Universität zu Köln
| | - Lena Roth
- Medizinische Fakultät, Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft (IMVR) der Humanwissenschaftlichen Fakultät und der Medizinischen Fakultät der Universität zu Köln
| | - Micheal Swora
- Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft (IMVR) der Humanwissenschaftlichen Fakultät und der Medizinischen Fakultät der Universität zu Köln
| | - Sophie Elisabeth Groß
- Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft (IMVR) der Humanwissenschaftlichen Fakultät und der Medizinischen Fakultät der Universität zu Köln.,LVR-Institut für Versorgungsforschung, LVR-Klinik Köln
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12
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Lamy S, Molinié F, Daubisse-Marliac L, Cowppli-Bony A, Ayrault-Piault S, Fournier E, Woronoff AS, Delpierre C, Grosclaude P. Using ecological socioeconomic position (SEP) measures to deal with sample bias introduced by incomplete individual-level measures: inequalities in breast cancer stage at diagnosis as an example. BMC Public Health 2019; 19:857. [PMID: 31266476 PMCID: PMC6604477 DOI: 10.1186/s12889-019-7220-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 06/20/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND When studying the influence of socioeconomic position (SEP) on health from data where individual-level SEP measures may be missing, ecological measures of SEP may prove helpful. In this paper, we illustrate the best use of ecological-level measures of SEP to deal with incomplete individual level data. To do this we have taken the example of a study examining the relationship between SEP and breast cancer (BC) stage at diagnosis. METHODS Using population based-registry data, all women over 18 years newly diagnosed with a primary BC in 2007 were included. We compared the association between advanced stage at diagnosis and individual SEP containing missing data with an ecological level SEP measure without missing data. We used three modelling strategies, 1/ based on patients with complete data for individual-SEP (n = 1218), or 2/ on all patients (n = 1644) using an ecological-level SEP as proxy for individual SEP and 3/ individual-SEP after imputation of missing data using an ecological-level SEP. RESULTS The results obtained from these models demonstrate that selection bias was introduced in the sample where only patients with complete individual SEP were included. This bias is redressed by using ecological-level SEP to impute missing data for individual SEP on all patients. Such a strategy helps to avoid an ecological bias due to the use of aggregated data to infer to individual level. CONCLUSION When individual data are incomplete, we demonstrate the usefulness of an ecological index to assess and redress potential selection bias by using it to impute missing individual SEP.
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Affiliation(s)
- Sébastien Lamy
- Laboratory of Epidemiology and Analyses in Public Health, Faculté de Médecine, UMR 1027 Inserm - Université Toulouse 3 Paul Sabatier, Equipe EQUITY labellisée par le Ligue nationale contre le cancer, 37 allées Jules Guesde, F-31000, Toulouse, France.
| | - Florence Molinié
- French network of Cancer registries (Francim), F-31000, Toulouse, France.,Loire-Atlantique / Vendée Cancer Registry, F-44093, Nantes, France.,SIRIC ILIAD, Nantes University Hospital, F-44093, Nantes, France
| | - Laetitia Daubisse-Marliac
- Laboratory of Epidemiology and Analyses in Public Health, Faculté de Médecine, UMR 1027 Inserm - Université Toulouse 3 Paul Sabatier, Equipe EQUITY labellisée par le Ligue nationale contre le cancer, 37 allées Jules Guesde, F-31000, Toulouse, France.,French network of Cancer registries (Francim), F-31000, Toulouse, France.,Tarn Cancer Registry, University Cancer Institute of Toulouse - Oncopole (IUCT-O), F-31000, Toulouse, France
| | - Anne Cowppli-Bony
- French network of Cancer registries (Francim), F-31000, Toulouse, France.,Loire-Atlantique / Vendée Cancer Registry, F-44093, Nantes, France.,SIRIC ILIAD, Nantes University Hospital, F-44093, Nantes, France
| | - Stéphanie Ayrault-Piault
- French network of Cancer registries (Francim), F-31000, Toulouse, France.,Loire-Atlantique / Vendée Cancer Registry, F-44093, Nantes, France.,SIRIC ILIAD, Nantes University Hospital, F-44093, Nantes, France
| | - Evelyne Fournier
- French network of Cancer registries (Francim), F-31000, Toulouse, France.,Doubs and Belfort territory Cancer Registry, Besançon University Hospital, F-25000, Besançon, France.,Resarch Unit EA3181, Universiy of Franche-Comté, F-25000, Besançon, France
| | - Anne-Sophie Woronoff
- French network of Cancer registries (Francim), F-31000, Toulouse, France.,Doubs and Belfort territory Cancer Registry, Besançon University Hospital, F-25000, Besançon, France.,Resarch Unit EA3181, Universiy of Franche-Comté, F-25000, Besançon, France
| | - Cyrille Delpierre
- Laboratory of Epidemiology and Analyses in Public Health, Faculté de Médecine, UMR 1027 Inserm - Université Toulouse 3 Paul Sabatier, Equipe EQUITY labellisée par le Ligue nationale contre le cancer, 37 allées Jules Guesde, F-31000, Toulouse, France
| | - Pascale Grosclaude
- Laboratory of Epidemiology and Analyses in Public Health, Faculté de Médecine, UMR 1027 Inserm - Université Toulouse 3 Paul Sabatier, Equipe EQUITY labellisée par le Ligue nationale contre le cancer, 37 allées Jules Guesde, F-31000, Toulouse, France.,French network of Cancer registries (Francim), F-31000, Toulouse, France.,Tarn Cancer Registry, University Cancer Institute of Toulouse - Oncopole (IUCT-O), F-31000, Toulouse, France
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13
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Deprivation and mass screening: Survival of women diagnosed with breast cancer in France from 2008 to 2010. Cancer Epidemiol 2019; 60:149-155. [DOI: 10.1016/j.canep.2019.03.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 02/22/2019] [Accepted: 03/29/2019] [Indexed: 02/06/2023]
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14
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Petitjean A, Smith-Palmer J, Valentine W, Tehard B, Roze S. Cost-effectiveness of bevacizumab plus paclitaxel versus paclitaxel for the first-line treatment of HER2-negative metastatic breast cancer in specialist oncology centers in France. BMC Cancer 2019; 19:140. [PMID: 30744578 PMCID: PMC6371553 DOI: 10.1186/s12885-019-5335-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 01/31/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Evidence from clinical trials suggests that the addition of bevacizumab to chemotherapy in the first-line treatment of patients with HER2-negative metastatic breast cancer improves progression-free survival (PFS) but not overall survival (OS). However, a retrospective analysis of real-world data from the French Comprehensive Cancer Centers (FCCC) through the Epidemiological Strategy and Medical Economics (ESME) Research Program, suggested that in this setting, the addition of bevacizumab may confer a significant benefit in terms of both PFS and OS. A cost-effectiveness analysis was performed to determine the cost-effectiveness of bevacizumab plus paclitaxel versus paclitaxel alone in the first-line treatment of HER2-negative metastatic breast cancer at specialist oncology centers in France. METHODS The analysis was performed using a three-state Markov model and clinical input data from N = 3426 HER2-negative metastatic breast cancer patients treated with bevacizumab plus paclitaxel or paclitaxel alone. The analysis was performed from a third party payer perspective over a 10-year time horizon; future costs and clinical outcomes were discounted at 4% per annum. RESULTS In the overall population, the addition of bevacizumab to paclitaxel led to incremental gain of 0.72 life years and 0.48 quality-adjusted life years (QALYs) relative to paclitaxel alone. The incremental lifetime cost of the addition of bevacizumab was EUR 27,390, resulting in an incremental cost-effectiveness ratio (ICER) of EUR 56,721 per QALY gained for bevacizumab plus paclitaxel versus paclitaxel alone. In a subgroup of triple negative patients the ICER was EUR 66,874 per QALY gained. CONCLUSIONS The analysis indicated that the combination of bevacizumab plus paclitaxel is likely to be cost-effective compared with paclitaxel alone for the first-line treatment of HER2-negative metastatic breast cancer in specialized oncology centers in France.
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15
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Bertaut A, Coudert J, Bengrine L, Dancourt V, Binquet C, Douvier S. Does mammogram attendance influence participation in cervical and colorectal cancer screening? A prospective study among 1856 French women. PLoS One 2018; 13:e0198939. [PMID: 29927995 PMCID: PMC6013094 DOI: 10.1371/journal.pone.0198939] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 05/29/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND We aimed to determine participation rates and factors associated with participation in colorectal (fecal occul blood test) and cervical cancer (Pap-smear) screening among a population of women participating in breast cancer screening. METHODS From August to October 2015, a self-administered questionnaire was sent by post to 2 900 women aged 50-65, living in Côte-d'Or, France, and who were up to date with mammogram screening. Polytomic logistic regression was used to identify correlates of participation in both cervical and colorectal cancer screenings. Participation in all 3 screenings was chosen as the reference. RESULTS Study participation rate was 66.3% (n = 1856). Besides being compliant with mammogram, respectively 78.3% and 56.6% of respondents were up to date for cervical and colorectal cancer screenings, while 46.2% were compliant with the 3 screenings. Consultation with a gynecologist in the past year was associated with higher chance of undergoing the 3 screenings or female cancer screenings (p<10-4), when consultation with a GP was associated with higher chance of undergoing the 3 screenings or organized cancer screenings (p<0.05). Unemployment, obesity, age>59 and yearly flu vaccine were associated with a lower involvement in cervical cancer screening. Women from high socio-economic classes were more likely to attend only female cancer screenings (p = 0.009). Finally, a low level of physical activity and tobacco use were associated with higher risk of no additional screening participation (p<10-3 and p = 0.027). CONCLUSIONS Among women participating in breast screening, colorectal and cervical cancer screening rates could be improved. Including communication about these 2 cancer screenings in the mammogram invitation could be worth to explore.
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Affiliation(s)
- Aurélie Bertaut
- Methodology and Biostatistics Unit, Centre Georges François Leclerc, Dijon, France
- * E-mail:
| | - Julien Coudert
- Medical Oncology Unit, Centre Georges François Leclerc, Dijon, France
| | - Leila Bengrine
- Medical Oncology Unit, Centre Georges François Leclerc, Dijon, France
| | - Vincent Dancourt
- ADECA 21-58, « Association pour le dépistage des cancers Côte-d’Or », Dijon, France
| | - Christine Binquet
- INSERM U1231-EPICAD Team, Burgundy-Franche Comte University, Dijon, France
- INSERM CIC1432, University Hospital, Dijon, France
| | - Serge Douvier
- Department of Gynecologic and Oncologic Surgery, University Hospital, Dijon, France
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16
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Belot A, Remontet L, Rachet B, Dejardin O, Charvat H, Bara S, Guizard AV, Roche L, Launoy G, Bossard N. Describing the association between socioeconomic inequalities and cancer survival: methodological guidelines and illustration with population-based data. Clin Epidemiol 2018; 10:561-573. [PMID: 29844706 PMCID: PMC5961638 DOI: 10.2147/clep.s150848] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Describing the relationship between socioeconomic inequalities and cancer survival is important but methodologically challenging. We propose guidelines for addressing these challenges and illustrate their implementation on French population-based data. METHODS We analyzed 17 cancers. Socioeconomic deprivation was measured by an ecological measure, the European Deprivation Index (EDI). The Excess Mortality Hazard (EMH), ie, the mortality hazard among cancer patients after accounting for other causes of death, was modeled using a flexible parametric model, allowing for nonlinear and/or time-dependent association between the EDI and the EMH. The model included a cluster-specific random effect to deal with the hierarchical structure of the data. RESULTS We reported the conventional age-standardized net survival (ASNS) and described the changes of the EMH over the time since diagnosis at different levels of deprivation. We illustrated nonlinear and/or time-dependent associations between the EDI and the EMH by plotting the excess hazard ratio according to EDI values at different times after diagnosis. The median excess hazard ratio quantified the general contextual effect. Lip-oral cavity-pharynx cancer in men showed the widest deprivation gap, with 5-year ASNS at 41% and 29% for deprivation quintiles 1 and 5, respectively, and we found a nonlinear association between the EDI and the EMH. The EDI accounted for a substantial part of the general contextual effect on the EMH. The association between the EDI and the EMH was time dependent in stomach and pancreas cancers in men and in cervix cancer. CONCLUSION The methodological guidelines proved efficient in describing the way socioeconomic inequalities influence cancer survival. Their use would allow comparisons between different health care systems.
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Affiliation(s)
- Aurélien Belot
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Non-Communicable Diseases and Trauma Direction, The French Public Health Agency, Saint-Maurice, France
- Department of Biostatistics and Bioinformatics, Hospices Civils de Lyon, Lyon, France
| | - Laurent Remontet
- Department of Biostatistics and Bioinformatics, Hospices Civils de Lyon, Lyon, France
- UMR 5558, Biometry and Evolutionary Biology Laboratory, Biostatistics Health Group, CNRS, University Lyon 1, Lyon, France
| | - Bernard Rachet
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Olivier Dejardin
- National Institute of Health and Medical Research U1086 ANTICIPE, Caen, France
- Calvados Digestive Cancer Registry, Centre Hospitalier Universitaire, Caen, France
| | - Hadrien Charvat
- Prevention Division, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Simona Bara
- Manche General Cancer Registry, Centre Hospitalier Public du Cotentin, Cherbourg-en-Cotentin, France
| | - Anne-Valérie Guizard
- National Institute of Health and Medical Research U1086 ANTICIPE, Caen, France
- Calvados General Cancer Registry, Centre François Baclesse, Caen, France
| | - Laurent Roche
- Department of Biostatistics and Bioinformatics, Hospices Civils de Lyon, Lyon, France
- UMR 5558, Biometry and Evolutionary Biology Laboratory, Biostatistics Health Group, CNRS, University Lyon 1, Lyon, France
| | - Guy Launoy
- National Institute of Health and Medical Research U1086 ANTICIPE, Caen, France
- Calvados Digestive Cancer Registry, Centre Hospitalier Universitaire, Caen, France
| | - Nadine Bossard
- Department of Biostatistics and Bioinformatics, Hospices Civils de Lyon, Lyon, France
- UMR 5558, Biometry and Evolutionary Biology Laboratory, Biostatistics Health Group, CNRS, University Lyon 1, Lyon, France
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17
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Knighton AJ. Is a Patient's Current Address of Record a Reasonable Measure of Neighborhood Deprivation Exposure? A Case for the Use of Point in Time Measures of Residence in Clinical Care. Health Equity 2018; 2:62-69. [PMID: 30283850 PMCID: PMC6071897 DOI: 10.1089/heq.2017.0005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Purpose: Interest is increasing in the use of geocoded patient address data to understand the effects that social determinants of health have on healthcare outcomes. Use of a patient's current address of record is often problematic given population mobility. Intragenerational economic mobility research suggests that patients will reside within neighborhoods with similar relative deprivation over time despite geographic mobility. The purpose of this study was to measure evidence of patient neighborhood deprivation persistence given a change in address of record. Methods: A retrospective cohort study of patients receiving active care in an integrated delivery system in a high-mobility United States region. Neighborhood deprivation was measured using a block-group level area deprivation index. Neighborhood deprivation persistence was measured as the probability that an individual with an address of record change remained within a neighborhood with a similar deprivation score. Logistic regression was used to conduct multivariate analysis. Results: Geographic mobility was highest among patients living in the most deprived neighborhoods versus least-deprived (odds ratio 1.75; 95% confidence interval: 1.71–1.79). Seventy-eight percent of all patients with a change of address did so to a neighborhood with a similar deprivation quintile. The probability that a random patient selected from the study had a change of address outside the same or neighboring quintile within a 1-year period ranged from 2% to 13%. Conclusions: Neighborhood deprivation persistence was high among this population of patients from a high mobility region. A current address of record is a reasonable indicator of patient exposure to neighborhood deprivation within a 1–3-year timeframe that is useful in evaluating healthcare disparities.
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Affiliation(s)
- Andrew J Knighton
- Intermountain Institute for Healthcare Delivery Research, Intermountain Healthcare, Salt Lake City, Utah
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18
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Canevelli M, Bruno G, Vico C, Zaccaria V, Lacorte E, Iavicoli I, Vanacore N, Cesari M. Socioeconomic disparities in clinical trials on Alzheimer's disease: a systematic review. Eur J Neurol 2018; 25:626-e43. [PMID: 29383812 DOI: 10.1111/ene.13587] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 01/19/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE There is now a wide consensus at recognizing social and economic circumstances as main determinants of an individual's health status. Nevertheless, characteristics relating to socioeconomic status (SES) are poorly described in research reports. The aim of the present review was to verify whether the SES of participants is adequately reported in interventional studies targeting Alzheimer's disease (AD), and to explore the impact of SES proxy measures on the efficacy of the considered medications. METHODS A systematic review of available randomized controlled trials (RCTs) on the currently marketed drugs for AD (i.e. cholinesterase inhibitors and memantine) was conducted by performing a structured search on PubMed and the Cochrane databases. The following indicators of SES were considered in the retained studies: (i) educational level, (ii) lifetime job category, (iii) income and (iv) wealth. The study quality was assessed using the Cochrane Risk of Bias Tool for Randomized Controlled Trials. RESULTS A total of 48 articles were finally selected. Overall, only eight RCTs reported data concerning the four considered SES indicators. Indeed, only information pertaining to the educational level of participants was provided. Only one RCT (n = 60) performed ad hoc, secondary analyses accounting for the SES of participating subjects. CONCLUSIONS The research and clinical relevance of SES has mistakenly been overlooked by the vast majority of RCTs on AD. A greater effort should be made to collect and report data on those SES indicators that may significantly affect the clinical manifestations and trajectories of patients with cognitive disturbances.
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Affiliation(s)
- M Canevelli
- Department of Human Neuroscience, Sapienza University, Rome
| | - G Bruno
- Department of Human Neuroscience, Sapienza University, Rome
| | - C Vico
- Department of Human Neuroscience, Sapienza University, Rome
| | - V Zaccaria
- Department of Human Neuroscience, Sapienza University, Rome
| | - E Lacorte
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome
| | - I Iavicoli
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - N Vanacore
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome
| | - M Cesari
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan.,Geriatric Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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19
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Lyle G, Hendrie GA, Hendrie D. Understanding the effects of socioeconomic status along the breast cancer continuum in Australian women: a systematic review of evidence. Int J Equity Health 2017; 16:182. [PMID: 29037209 PMCID: PMC5644132 DOI: 10.1186/s12939-017-0676-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 10/03/2017] [Indexed: 12/31/2022] Open
Abstract
Background Globally, the provision of equitable outcomes for women with breast cancer is a priority for governments. However, there is growing evidence that a socioeconomic status (SES) gradient exists in outcomes across the breast cancer continuum – namely incidence, diagnosis, treatment, survival and mortality. This systematic review describes this evidence and, because of the importance of place in defining SES, findings are limited to the Australian experience. Methods An on-line search of PubMed and the Web of Science identified 44 studies published since 1995 which examined the influence of SES along the continuum. The critique of studies included the study design, the types and scales of SES variable measured, and the results in terms of direction and significance of the relationships found. To aid in the interpretation of results, the findings were discussed in the context of a systems dynamic feedback diagram. Results We found 67 findings which reported 107 relationships between SES within outcomes along the continuum. Results suggest no differences in the participation in screening by SES. Higher incidence was reported in women with higher SES whereas a negative association was reported between SES and diagnosis. Associations with treatment choice were specific to the treatment choice undertaken. Some evidence was found towards greater survival for women with higher SES, however, the evidence for a SES relationship with mortality was less conclusive. Conclusions In a universal health system such as that in Australia, evidence of an SES gradient exists, however, the strength and direction of this relationship varies along the continuum. This is a complex relationship and the heterogeneity in study design, the SES indicator selected and its representative scale further complicates our understanding of its influence. More complex multilevel studies are needed to better understand these relationships, the interactions between predictors and to reduce biases introduced by methodological issues.
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Affiliation(s)
- Greg Lyle
- Centre for Population Health Research, Curtin University, Perth, Australia.
| | | | - Delia Hendrie
- School of Public Health, Curtin University, Perth, Australia
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20
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Dasgupta P, Youl PH, Aitken JF, Turrell G, Baade P. Geographical differences in risk of advanced breast cancer: Limited evidence for reductions over time, Queensland, Australia 1997-2014. Breast 2017; 36:60-66. [PMID: 28985515 DOI: 10.1016/j.breast.2017.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 09/05/2017] [Accepted: 09/27/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Reducing geographical inequalities in breast cancer stage remains a key focus of public health policy. We explored whether patterns of advanced breast cancer by residential accessibility and disadvantage in Queensland, Australia, have changed over time. METHODS Population-based cancer registry study of 38,706 women aged at least 30 years diagnosed with a first primary invasive breast cancer of known stage between 1997 and 2014. Multilevel logistic regression was used to examine temporal changes in associations of area-level factors with odds of advanced disease after adjustment for individual-level factors. RESULTS Overall 19,401 (50%) women had advanced breast cancer. Women from the most disadvantaged areas had higher adjusted odds (OR = 1.23 [95%CI 1.13, 1.32]) of advanced disease than those from least disadvantaged areas, with no evidence this association had changed over time (interaction p = 0.197). Living in less accessible areas independently increased the adjusted odds (OR = 1.18 [1.09, 1.28]) of advanced disease, with some evidence that the geographical inequality had reduced over time (p = 0.045). Sensitivity analyses for un-staged cases showed that the original associations remained, regardless of assumptions made about the true stage distribution. CONCLUSIONS Both geographical and residential socioeconomic inequalities in advanced stage diagnoses persist, potentially reflecting barriers in accessing diagnostic services. Given the role of screening mammography in early detection of breast cancer, the lack of population-based data on private screening limits our ability to determine overall participation rates by residential characteristics. Without such data, the efficacy of strategies to reduce inequalities in breast cancer stage will remain compromised.
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Affiliation(s)
- Paramita Dasgupta
- Cancer Council Queensland, PO Box 201, Spring Hill, QLD 4004, Australia.
| | - Philippa H Youl
- University of the Sunshine Coast, Sippy Downs, QLD, 4556, Australia.
| | - Joanne F Aitken
- Cancer Council Queensland, PO Box 201, Spring Hill, QLD 4004, Australia; School of Public Health and Social Work, Queensland University of Technology, Herston Road, Kelvin Grove, QLD, 4059, Australia; School of Population Health, University of Queensland, Brisbane, Australia.
| | - Gavin Turrell
- Institute for Health and Ageing, Australian Catholic University, Melbourne, 3065, Victoria, Australia.
| | - Peter Baade
- Cancer Council Queensland, PO Box 201, Spring Hill, QLD 4004, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Parklands Drive, Southport, QLD, 4222, Australia; School of Mathematical Sciences, Queensland University of Technology, Gardens Point, Brisbane, QLD, 4000, Australia.
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21
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Davoudi Monfared E, Mohseny M, Amanpour F, Mosavi Jarrahi A, Moradi Joo M, Heidarnia MA. Relationship of Social Determinants of Health with the Three-year Survival Rate of Breast Cancer. Asian Pac J Cancer Prev 2017; 18:1121-1126. [PMID: 28547951 PMCID: PMC5494225 DOI: 10.22034/apjcp.2017.18.4.1121] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: Social determinants of health are among the key factors affecting the pathogenesis of diseases. Considering the increasingly high prevalence of breast cancer and the association of social determinants of health with its occurrence, related morbidity and mortality and survival rate, this study sought to assess the relationship of three-year survival rate of breast cancer with social determinants of health. Materials and Methods: This cohort study was conducted on males and females presenting to the Cancer Research Center of Shohada-E-Tajrish Hospital from 2006 to 2010 with definite diagnosis of breast cancer. Data were collected via phone interviews. Kaplan-Meier and Cox regression was fitted using SPSS (version 18) and PH assumption was tested by STATA (version 11) software. Results: The study was performed on 797 breast cancer patients, aged 25-93 years with mean age of 54.66 (SD=11.86) years. After 3 years from diagnosing cancer 700 (87.8%) patients were alive and 97 (12.2%) patients were dead. Using log rank test, there was relationship between 3-year survivals with age, education, childhood residence, sibling, treatment type, and district were significant (p<0.05). Using Cox PH regression, 3-year survival was related to age, level of education, municipal district of residence and childhood condition (p<0.05). Conclusion: Social determinants of health such as childhood condition, city region residency, level of education and age affect the three-year survival rate of breast cancer. Future studies must focus on the effect of childhood social class on the survival rates of cancers, which have been paid less attention to.
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Affiliation(s)
- Esmat Davoudi Monfared
- Department of Community
Medicine, Medical School, Shahid Beheshti University of Medical Sciences,Tehran, Iran.
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22
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Delaloge S, Bonastre J, Borget I, Garbay JR, Fontenay R, Boinon D, Saghatchian M, Mathieu MC, Mazouni C, Rivera S, Uzan C, André F, Dromain C, Boyer B, Pistilli B, Azoulay S, Rimareix F, Bayou EH, Sarfati B, Caron H, Ghouadni A, Leymarie N, Canale S, Mons M, Arfi-Rouche J, Arnedos M, Suciu V, Vielh P, Balleyguier C. The challenge of rapid diagnosis in oncology: Diagnostic accuracy and cost analysis of a large-scale one-stop breast clinic. Eur J Cancer 2016; 66:131-7. [PMID: 27569041 DOI: 10.1016/j.ejca.2016.06.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 05/30/2016] [Accepted: 06/25/2016] [Indexed: 12/16/2022]
Abstract
PURPOSE Rapid diagnosis is a key issue in modern oncology, for which one-stop breast clinics are a model. We aimed to assess the diagnosis accuracy and procedure costs of a large-scale one-stop breast clinic. PATIENTS AND METHODS A total of 10,602 individuals with suspect breast lesions attended the Gustave Roussy's regional one-stop breast clinic between 2004 and 2012. The multidisciplinary clinic uses multimodal imaging together with ultrasonography-guided fine needle aspiration for masses and ultrasonography-guided and stereotactic biopsies as needed. Diagnostic accuracy was assessed by comparing one-stop diagnosis to the consolidated diagnosis obtained after surgery or biopsy or long-term monitoring. The medical cost per patient of the care pathway was assessed from patient-level data collected prospectively. RESULTS Sixty-nine percent of the patients had masses, while 31% had micro-calcifications or other non-mass lesions. In 75% of the cases (87% of masses), an exact diagnosis could be given on the same day. In the base-case analysis (i.e. considering only benign and malignant lesions at one-stop and at consolidated diagnoses), the sensitivity of the one-stop clinic was 98.4%, specificity 99.8%, positive and negative predictive values 99.7% and 99.0%. In the sensitivity analysis (reclassification of suspect, atypical and undetermined lesions), diagnostic sensitivity varied from 90.3% to 98.5% and specificity varied from 94.3% to 99.8%. The mean medical cost per patient of one-stop diagnostic procedure was €420. CONCLUSIONS One-stop breast clinic can provide timely and cost-efficient delivery of highly accurate diagnoses and serve as models of care for multiple settings, including rapid screening-linked diagnosis.
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Affiliation(s)
- Suzette Delaloge
- Gustave Roussy, Université Paris-Saclay, Department of Medical Oncology, Villejuif, F-94805, France.
| | - Julia Bonastre
- Gustave Roussy, Université Paris-Saclay, Department of Biostatistics, Epidemiology and Health Economics, Villejuif, F-94805, France; INSERM U1018, CESP Centre for Research in Epidemiology and Population Health, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Isabelle Borget
- Gustave Roussy, Université Paris-Saclay, Department of Biostatistics, Epidemiology and Health Economics, Villejuif, F-94805, France; INSERM U1018, CESP Centre for Research in Epidemiology and Population Health, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Jean-Rémi Garbay
- Gustave Roussy, Université Paris-Saclay, Department of Surgery, Villejuif, F-94805, France
| | - Rachel Fontenay
- Gustave Roussy, Université Paris-Saclay, Department of Biostatistics, Epidemiology and Health Economics, Villejuif, F-94805, France; INSERM U1018, CESP Centre for Research in Epidemiology and Population Health, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Diane Boinon
- Gustave Roussy, Université Paris-Saclay, Department of Supportive Care, Villejuif, F-94805, France
| | - Mahasti Saghatchian
- Gustave Roussy, Université Paris-Saclay, Department of Medical Oncology, Villejuif, F-94805, France
| | - Marie-Christine Mathieu
- Gustave Roussy, Université Paris-Saclay, Department of Pathology, Villejuif, F-94805, France
| | - Chafika Mazouni
- Gustave Roussy, Université Paris-Saclay, Department of Surgery, Villejuif, F-94805, France
| | - Sofia Rivera
- Gustave Roussy, Université Paris-Saclay, Department of Radiation Therapy, Villejuif, F-94805, France
| | - Catherine Uzan
- Gustave Roussy, Université Paris-Saclay, Department of Surgery, Villejuif, F-94805, France
| | - Fabrice André
- Gustave Roussy, Université Paris-Saclay, Department of Medical Oncology, Villejuif, F-94805, France
| | - Clarisse Dromain
- Gustave Roussy, Université Paris-Saclay, Department of Radiology, Villejuif, F-94805, France
| | - Bruno Boyer
- Gustave Roussy, Université Paris-Saclay, Department of Radiology, Villejuif, F-94805, France
| | - Barbara Pistilli
- Gustave Roussy, Université Paris-Saclay, Department of Medical Oncology, Villejuif, F-94805, France
| | - Sandy Azoulay
- Gustave Roussy, Université Paris-Saclay, Department of Pathology, Villejuif, F-94805, France
| | - Françoise Rimareix
- Gustave Roussy, Université Paris-Saclay, Department of Surgery, Villejuif, F-94805, France
| | - El-Hadi Bayou
- Gustave Roussy, Université Paris-Saclay, Department of Radiology, Villejuif, F-94805, France
| | - Benjamin Sarfati
- Gustave Roussy, Université Paris-Saclay, Department of Surgery, Villejuif, F-94805, France
| | - Hélène Caron
- Gustave Roussy, Université Paris-Saclay, Department of Medical Oncology, Villejuif, F-94805, France
| | - Amal Ghouadni
- Gustave Roussy, Université Paris-Saclay, Department of Medical Oncology, Villejuif, F-94805, France
| | - Nicolas Leymarie
- Gustave Roussy, Université Paris-Saclay, Department of Surgery, Villejuif, F-94805, France
| | - Sandra Canale
- Gustave Roussy, Université Paris-Saclay, Department of Radiology, Villejuif, F-94805, France
| | - Muriel Mons
- Gustave Roussy, Université Paris-Saclay, Department of Medical Information, Villejuif, F-94805, France
| | - Julia Arfi-Rouche
- Gustave Roussy, Université Paris-Saclay, Department of Radiology, Villejuif, F-94805, France
| | - Monica Arnedos
- Gustave Roussy, Université Paris-Saclay, Department of Medical Oncology, Villejuif, F-94805, France
| | - Voichita Suciu
- Gustave Roussy, Université Paris-Saclay, Department of Pathology, Villejuif, F-94805, France
| | - Philippe Vielh
- Gustave Roussy, Université Paris-Saclay, Department of Pathology, Villejuif, F-94805, France
| | - Corinne Balleyguier
- Gustave Roussy, Université Paris-Saclay, Department of Radiology, Villejuif, F-94805, France
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23
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Delaloge S, Bachelot T, Bidard FC, Espie M, Brain E, Bonnefoi H, Gligorov J, Dalenc F, Hardy-Bessard AC, Azria D, Jacquin JP, Lemonnier J, Jacot W, Goncalves A, Coutant C, Ganem G, Petit T, Penault-Llorca F, Debled M, Campone M, Levy C, Coudert B, Lortholary A, Venat-Bouvet L, Grenier J, Bourgeois H, Asselain B, Arvis J, Castro M, Tardivon A, Cox DG, Arveux P, Balleyguier C, André F, Rouzier R. [Breast cancer screening: On our way to the future]. Bull Cancer 2016; 103:753-63. [PMID: 27473920 DOI: 10.1016/j.bulcan.2016.06.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 06/02/2016] [Accepted: 06/19/2016] [Indexed: 01/24/2023]
Abstract
Breast cancer remains a potentially lethal disease, which requires aggressive treatments and is associated with long-term consequences. Its prognosis is linked to both tumor biology and burden at diagnosis. Although treatments have allowed important improvements in prognosis over the past 20 years, breast cancer screening remains necessary. Mammographic screening allows earlier stage diagnoses and a decrease of breast cancer specific mortality. However, breast cancer screening modalities should be revised with the objective to address demonstrated limitations of mammographic screening (limited benefit, imperfect sensitivity and specificity, overdiagnoses, radiation-induced morbidity). Furthermore, both objective and perceived performances of screening procedures should be improved. Numerous large international efforts are ongoing, leading to scientific progresses that should have rapid clinical implications in this area. Among them is improvement of imaging techniques performance, development of real time diagnosis, and development of new non radiological screening techniques such as the search for circulating tumor DNA, development of biomarkers able to allow precise risk evaluation and stratified screening. As well, overtreatment is currently addressed by biomarker-based de-escalation clinical trials. These advances need to be associated with strong societal support, as well as major paradigm changes regarding the way health and cancer prevention is perceived by individuals.
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Affiliation(s)
- Suzette Delaloge
- Université Paris Saclay, institut Gustave-Roussy, département de médecine oncologique, Inserm U981, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
| | - Thomas Bachelot
- Centre Léon-Bérard, département de cancérologie médicale, 28, rue Laënnec, 69008 Lyon cedex 08, France
| | - François-Clément Bidard
- Université de recherche Paris, sciences et lettres, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - Marc Espie
- Hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Etienne Brain
- Institut Curie, Saint-Cloud, 35, rue Dailly, 92210 Saint-Cloud, France; Université Versailles-Saint-Quentin, 78180 Montigny-le-Bretonneux, France
| | - Hervé Bonnefoi
- Université de Bordeaux, institut Bergonie, 229, cours de l'Argonne, 33000 Bordeaux, France
| | - Joseph Gligorov
- Hôpital Tenon, université Paris-Sorbonne, Inserm U938, 4, rue de la Chine, 75020 Paris, France
| | - Florence Dalenc
- Institut universitaire du cancer-Toulouse oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | | | - David Azria
- Université de Montpellier, institut du cancer, IRCM U1194, 34298 Montpellier, France
| | - Jean-Philippe Jacquin
- Institut de cancérologie de la Loire, 108 B, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France
| | | | - William Jacot
- Université de Montpellier, institut du cancer, IRCM U1194, 34298 Montpellier, France
| | - Anthony Goncalves
- Université Aix-Marseille, institut Paoli-Calmettes, Inserm U1068, 232, boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - Charles Coutant
- Université de Bourgogne, centre Georges-François-Leclerc, 1, rue du Pr-Marion, 21000 Dijon, France
| | - Gérard Ganem
- Centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France
| | - Thierry Petit
- Université de Strasbourg, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67000 Strasbourg, France
| | | | - Marc Debled
- Université de Bordeaux, institut Bergonie, 229, cours de l'Argonne, 33000 Bordeaux, France
| | - Mario Campone
- Institut d'oncologie de l'Ouest, Inserm U892, IRT-UN, 8, quai Moncousu, 44007 Nantes cedex, France
| | - Christelle Levy
- Centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - Bruno Coudert
- Université de Bourgogne, centre Georges-François-Leclerc, 1, rue du Pr-Marion, 21000 Dijon, France
| | - Alain Lortholary
- Centre Catherine-de-Sienne, 2, rue Éric-Tabarly, 44202 Nantes, France
| | - Laurence Venat-Bouvet
- CHU de Limoges, service d'oncologie médicale, 22, avenue Martin-Luther-King, 87000 Limoges, France
| | - Julien Grenier
- Institut Sainte-Catherine, 250, chemin de Baignes-Pieds, 84918 Avignon cedex 9, France
| | | | | | - Johanna Arvis
- Ligue nationale contre le cancer, comité du Lot, 28, boulevard Gambetta, 46000 Cahors, France
| | - Martine Castro
- Europadonna France, 14, rue Corvisart, 75013 Paris, France
| | - Anne Tardivon
- Université de recherche Paris, sciences et lettres, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - David G Cox
- Université de Lyon, 69000 Lyon, France; Université Lyon 1, 69100 Villeurbanne, France; Centre de recherche en cancérologie de Lyon, Inserm U1052, CNRS UMR5286, 69000 Lyon, France; Centre Léon-Bérard, 69008 Lyon, France
| | - Patrick Arveux
- Registre de Côte d'Or, centre Georges-François-Leclerc, 1, rue du Pr-Marion, 21000 Dijon, France
| | - Corinne Balleyguier
- Institut Gustave-Roussy, département d'imagerie médicale, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| | - Fabrice André
- Université Paris Saclay, institut Gustave-Roussy, département de médecine oncologique, Inserm U981, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| | - Roman Rouzier
- Université de recherche Paris, sciences et lettres, institut Curie, 26, rue d'Ulm, 75005 Paris, France; Institut Curie, Saint-Cloud, 35, rue Dailly, 92210 Saint-Cloud, France; Université Versailles-Saint-Quentin, 78180 Montigny-le-Bretonneux, France
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