Breast cancer care in the Canada and the United States: ecological comparisons of extremely impoverished and affluent urban neighborhoods.
This study examined the differential effect of extreme impoverishment on breast cancer care in urban Canada and the United States. Ontario and California registry-based samples diagnosed between 1998 and 2000 were followed until 2006. Extremely poor and affluent neighborhoods were compared. Poverty was associated with non-localized disease, surgical and radiation therapy (RT) waits, non-receipt of breast conserving surgery, RT and hormonal therapy, and shorter survival in California, but not in Ontario. Extremely poor Ontario women were consistently advantaged on care indices over their California counterparts. More inclusive health insurance coverage in Canada seems the most plausible explanation for such Canadian breast cancer care advantages.
Gorey
Kevin M
KM
School of Social Work, University of Windsor, 401 Sunset Avenue, Windsor, Ontario, Canada N9B 3P4. gorey@uwindsor.ca
Luginaah
Isaac N
IN
Hamm
Caroline
C
Fung
Karen Y
KY
Holowaty
Eric J
EJ
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy*; D002140:California; D002170:Canada; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008875:Middle Aged; D009864:Ontario; D011203:Poverty; D012042:Registries; D012923:Social Class; D013534:Survival; D014481:United States; D014505:Urban Population