Suzanne P Moore1,2, Isabelle Soerjomataram3, Adèle C Green4,5, Gail Garvey6, Jennifer Martin7,8, Patricia C Valery6,3,4. 1. Division of Epidemiology and Health Systems, Menzies School of Health Research, Charles Darwin University, Level 1/147 Wharf Street, Brisbane Adelaide Street, Spring Hill, PO Box 10639, Brisbane, QLD, 4000, Australia. suzanne.moore@menzies.edu.au. 2. Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France. suzanne.moore@menzies.edu.au. 3. Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France. 4. Cancer and Population Studies Group, QIMR Berghofer of Medical Research Institute, Brisbane, Queensland, Australia. 5. CRUK Manchester Institute and University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. 6. Division of Epidemiology and Health Systems, Menzies School of Health Research, Charles Darwin University, Level 1/147 Wharf Street, Brisbane Adelaide Street, Spring Hill, PO Box 10639, Brisbane, QLD, 4000, Australia. 7. School of Medicine, University of Queensland and Princess Alexandra Hospital, Brisbane, Queensland, Australia. 8. School of Medicine, University of Newcastle, Callaghan, NSW, Australia.
Abstract
OBJECTIVES: We compared patterns of care, comorbidity, disability-adjusted life-years (DALYs) and survival in Indigenous and non-Indigenous women with breast cancer in Queensland, Australia (1998-2004). METHODS: A cohort study of Indigenous (n = 110) and non-Indigenous women (n = 105), frequency matched on age and remoteness. We used Pearson's Chi-squared analysis to compare proportions, hazard models to assess survival differences and calculated disability-adjusted life years (DALYs). RESULTS: Indigenous women were more likely to be socially disadvantaged (43 vs. 20 %, p < 0.01) have comorbidity (42 vs. 18 % p < 0.01), and have regional spread or distant metastasis (metastasis, 51 vs. 36 %, p = 0.02) than non-Indigenous women; there was no difference in treatment patterns. More Indigenous women died in the follow-up period (p = 0.01). DALY's were 469 and 665 per 100,000 for Indigenous and non-Indigenous women, respectively, with a larger proportion of the burden attributed to premature death among the former (63 vs. 59 %). CONCLUSIONS: Indigenous women with breast cancer received comparable treatment to their non-Indigenous counterparts. The higher proportion of DALYs related to early death in Indigenous women suggests higher fatality with breast cancer in this group. Later stage at diagnosis and higher comorbidity presence among Indigenous women reinforce the need for early detection and improved management of co-existing disease.
OBJECTIVES: We compared patterns of care, comorbidity, disability-adjusted life-years (DALYs) and survival in Indigenous and non-Indigenous women with breast cancer in Queensland, Australia (1998-2004). METHODS: A cohort study of Indigenous (n = 110) and non-Indigenous women (n = 105), frequency matched on age and remoteness. We used Pearson's Chi-squared analysis to compare proportions, hazard models to assess survival differences and calculated disability-adjusted life years (DALYs). RESULTS: Indigenous women were more likely to be socially disadvantaged (43 vs. 20 %, p < 0.01) have comorbidity (42 vs. 18 % p < 0.01), and have regional spread or distant metastasis (metastasis, 51 vs. 36 %, p = 0.02) than non-Indigenous women; there was no difference in treatment patterns. More Indigenous women died in the follow-up period (p = 0.01). DALY's were 469 and 665 per 100,000 for Indigenous and non-Indigenous women, respectively, with a larger proportion of the burden attributed to premature death among the former (63 vs. 59 %). CONCLUSIONS: Indigenous women with breast cancer received comparable treatment to their non-Indigenous counterparts. The higher proportion of DALYs related to early death in Indigenous women suggests higher fatality with breast cancer in this group. Later stage at diagnosis and higher comorbidity presence among Indigenous women reinforce the need for early detection and improved management of co-existing disease.
Entities:
Keywords:
Breast cancer; Cancer stage; Comorbidities; Disability-adjusted life years; Indigenous; Treatment
Authors: David Banham; David Roder; Dorothy Keefe; Gelareh Farshid; Marion Eckert; Natasha Howard; Karla Canuto; Alex Brown Journal: BMC Health Serv Res Date: 2019-06-14 Impact factor: 2.655
Authors: Vita Christie; Debbie Green; Janaki Amin; Christopher Pyke; Karen Littlejohn; John Skinner; Deb McCowen; Kylie Gwynne Journal: Int J Environ Res Public Health Date: 2021-06-04 Impact factor: 3.390
Authors: David Banham; David Roder; Marion Eckert; Natasha J Howard; Karla Canuto; Alex Brown Journal: BMC Health Serv Res Date: 2019-10-29 Impact factor: 2.655