Improving breast cancer outcomes for Aboriginal women: a mixed-methods study protocol

Breast cancer screening participation in women using mental health services in NSW, Australia: a population study

PURPOSE

Population screening programs have contributed to reduced breast cancer mortality, but disadvantaged or vulnerable groups may not have shared these improvements. In North American and European studies, women living with mental health conditions have reduced breast screening rates. There are no current Australasian data to support health system planning and improvement strategies.

METHODS

The New South Wales (NSW) BreastScreen program offers free screening to NSW women aged 50-74. We compared 2-year breast screening rates for mental health service users (n = 33,951) and other NSW women (n = 1,051,495) in this target age range, after standardisation for age, socioeconomic status and region of residence. Mental health service contacts were identified through linkage to hospital and community mental health data.

RESULTS

Only 30.3% of mental health service users participated in breast screening, compared with 52.7% of other NSW women (crude incidence rate ratio 0.57, 95% CI 0.56-0.59). Standardisation for age, socioeconomic disadvantage or rural residence did not alter this screening gap. Around 7000 fewer women received screening than would be expected from comparable population rates. Screening gaps were largest in women over 60 and in socioeconomically advantaged areas. Women with severe or persistent mental illness had slightly higher screening rates than other mental health service users.

CONCLUSIONS

Low breast cancer screening participation rates for NSW mental health service users suggest significant risk of later detection, possibly leading to more extensive treatment and premature mortality. Focussed strategies are needed to support greater breast screening participation for NSW women who use mental health services.

Improving Breast Cancer Outcomes for Indigenous Women in Australia

In Australia, the incidence rate of breast cancer is lower in Indigenous* women than non-Indigenous women; however, the mortality rate is higher, with Indigenous women 1.2 times more likely to die from the disease. This paper provides practical and achievable solutions to improve health outcomes for Indigenous women with breast cancer in Australia. This research employed the Context-Mechanism-Outcome (CMO) framework to reveal potential mechanisms and contextual factors that influence breast cancer outcomes for Indigenous women, stratified into multiple levels, namely, micro (interpersonal), meso (systemic) and macro (policy) levels. The CMO framework allowed us to interpret evidence regarding Indigenous women and breast cancer and provides nine practical ways to improve health outcomes and survival rates.

"Everyone needs a Deb": what Australian indigenous women say about breast cancer screening and treatment services

BACKGROUND

Breast cancer continues to be the second most diagnosed cancer overall and the most diagnosed cancer for women in Australia. While mortality rates overall have declined in recent years, Indigenous women continue to be diagnosed at more marginal rates (0.9 times) and are more likely to die (1.2 times). The literature provides a myriad of reasons for this; however, the voices of Indigenous women are largely absent. This study sets out to understand what is happening from the perspectives of Australian Indigenous women with a view to charting culturally safer pathways that improve participation in screening and treatment by Indigenous women.

METHODS

This co-design study was conducted using semi-structured, in-depth interviews and focus group discussions. Recruitment of study participants was via snowball sampling. Participants were subsequently consented into the study through the Aboriginal Health Service and the research team. Interviews were audio recorded and transcribed verbatim, and data coded in NVivo12 using inductive thematic analysis.

RESULTS

A total of 21 Indigenous women and 14 health service providers were interviewed predominantly from the same regional/rural area in NSW, with a small proportion from other states in Australia. Six major themes were identified: Access, Awareness, Community and Family, Lack of control, Negative feelings and associations and Role of services.

CONCLUSION

To improve access and participation of Indigenous women and ultimately improve mortality rates, breast cancer services must explicitly address cultural and community needs.

Analysis of Trending Topics in Breast Cancer Articles From an Altmetric Perspective

Background

It is widely known that social media has an impact on politics and the economy. The Altmetric Attention Score (AAS) is a new Web-based metric that was recently developed for use in the scientific field. The objective of this study was to assess which recent studies on the topic of breast cancer received the most attention from the general public.

Methodology

An Altmetric Explorer search was performed on January 7, 2022, to extract the following information: journal name, impact factor (IF), year of publication, article topic, article type, and level of evidence.

Results

The journal that published articles that received the most attention on social media was the New England Journal of Medicine (n = 8). All of the articles were published in journals in the highest IF quartile. The most frequent top three subjects in the top 50 articles were “treatment and management,” “risk factors for breast cancer,” and “breast cancer screening.” The number of articles with a level of evidence of 1, 2, 3, and 4 was 12, 17, 17, and 4, respectively. The correlation between AAS and citation was not significant.

Conclusions

The AAS seems to be a more reliable assessment of public perception of breast cancer. We propose that combining the AAS and traditional metrics may provide a more detailed description of scientific research output.