title: Intra-urban differences in breast cancer mortality: a study from the city of Malmö in Sweden.
abstract: OBJECTIVE
  To assess whether in an urban population stage at breast cancer diagnosis is related to area of living and to what extent intra-urban differences in breast cancer mortality are related to incidence respectively stage at diagnosis.
  
  
  METHODS
  National registries were used to identify cases. Mortality in 17 residential areas was studied in relation to incidence and stage distribution using linear regression analysis. Areas with high and low breast cancer mortality, incidence and proportion of stage II+ tumours at diagnosis were also compared in terms of their sociodemographic profile.
  
  
  METHODS
  City of Malmö in southern Sweden.
  
  
  METHODS
  The 1675 incident breast cancer cases and 448 deaths that occurred in women above 45 years of age in Malmö 1986-96.
  
  
  RESULTS
  Average annual age standardised breast cancer mortality ranged between residential areas, from 35/10(5) to 107/10(5), p = 0.04. Mortality of breast cancer was not correlated to incidence, r = 0.22, p = 0.39. The ratio of stage II+/0-I cancer incidence varied between areas from 0.45 to 1.99 and was significantly correlated to breast cancer mortality, r = 0.53, p = 0.03. Areas with high proportion of stage II+ cancers and high mortality/incidence ratio were characterised by a high proportion of residentials receiving income support, being foreigners and current smokers.
  
  
  CONCLUSIONS
  Within this urban population there were marked differences in breast cancer mortality between residential areas. Stage at diagnosis, but not incidence, contributed to the pattern of mortality. Areas with high proportion of stage II+ tumours differed unfavourably in several sociodemographic aspects from the city average.
authors.affiliation: Department of Community Medicine, Lund University, Malmö University Hospital, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Manjer
authors.forename: G
authors.initials: G
authors.lastname: Berglund
authors.forename: L
authors.initials: L
authors.lastname: Bondesson
authors.forename: J P
authors.initials: JP
authors.lastname: Garne
authors.forename: L
authors.initials: L
authors.lastname: Janzon
authors.forename: A
authors.initials: A
authors.lastname: Lindgren
authors.forename: J
authors.initials: J
authors.lastname: Malina
authors.forename: S
authors.initials: S
authors.lastname: Matson
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008327:Mammography; D008875:Middle Aged; D009367:Neoplasm Staging; D012042:Registries; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*