Rural-urban differences in the presentation, management and survival of breast cancer in Western Australia.
From all women diagnosed with invasive breast cancer in 1999 in Western Australia, rural and urban women were compared with regard to mode of detection, tumour characteristics at presentation, diagnostic investigations, treatment and survival. Women from rural areas with breast cancer (n=206, 23%) were less likely to have open biopsy with frozen section (P<0.001), breast-conserving surgery (P<0.001), adjuvant radiotherapy (P=0.004) and hormonal therapy (P=0.03), and were less likely to be treated by a high caseload breast cancer surgeon (P<0.001). Adjusting for age and tumour characteristics, rural women had an increased likelihood of death within 5 years of breast cancer diagnosis (HR 1.62, 95% CI 1.10-2.38). This difference was not significant after adjustment for treatment factors (HR 1.36, 95% CI 0.90-2.04).
Mitchell
K J
KJ
School of Population Health, M431, University of Western Australia, 35 Stirling Hwy, Crawley, Western Australia 6009, Australia.
Fritschi
L
L
Reid
A
A
McEvoy
S P
SP
Ingram
D M
DM
Jamrozik
K
K
Clayforth
C
C
Byrne
M J
MJ
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008408:Mastectomy / Q000706:statistics & numerical data; D008875:Middle Aged; D009367:Neoplasm Staging; D011878:Radiotherapy / Q000706:statistics & numerical data; D012423:Rural Health; D015996:Survival Rate; D014504:Urban Health; D014904:Western Australia / Q000453:epidemiology
D000970:Antineoplastic Agents