title: Temporal trends show improved breast cancer survival in Australia but widening urban-rural differences.
abstract: We examined geographic patterns in breast cancer survival over time using population-based data for breast cancer diagnosed between 1987 and 2007 in New South Wales, Australia. We found that five-year relative survival increased during the entire study period. Multivariable analysis indicated that there was little geographic variation in 1992-1996, but in 1997-2001 and 2002-2007 geographic variation was statistically significant (P < 0.01), with women living in rural areas having higher risk of death from breast cancer. The underlying reasons for this widening survival disparity must be identified so that appropriately targeted interventions can be implemented and the disparity reduced.
authors.affiliation: Cancer Research Division, Cancer Council New South Wales, Sydney, Australia; Sydney School of Public Health, University of Sydney, Sydney, Australia. Electronic address: xueqiny@nswcc.org.au.
authors.forename: Xue Qin
authors.initials: XQ
authors.lastname: Yu
authors.affiliation: Cancer Research Division, Cancer Council New South Wales, Sydney, Australia; Sydney School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Qingwei
authors.initials: Q
authors.lastname: Luo
authors.affiliation: Cancer Research Division, Cancer Council New South Wales, Sydney, Australia.
authors.forename: Clare
authors.initials: C
authors.lastname: Kahn
authors.affiliation: Cancer Research Division, Cancer Council New South Wales, Sydney, Australia; Sydney School of Public Health, University of Sydney, Sydney, Australia; School of Public Health and Community Medicine, University of NSW, Sydney, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.
authors.forename: Dianne L
authors.initials: DL
authors.lastname: O'Connell
authors.affiliation: Sydney School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Nehmat
authors.initials: N
authors.lastname: Houssami
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality*; D005260:Female; D062306:Geography, Medical; D054624:Health Status Disparities; D006801:Humans; D008875:Middle Aged; D009517:New South Wales; D012042:Registries; D012424:Rural Population / Q000706:statistics & numerical data*; D016019:Survival Analysis; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Breast cancer; Geography; Inequality; Population health; Survival; Temporal trends