title: Age-related socio-economic and geographic disparities in breast cancer stage at diagnosis: a population-based study.
abstract: BACKGROUND
  This study aimed to determine the impact of socio-economic and geographic disparities on disease stage at diagnosis according to age in breast cancer (BC) patients. Secondary purpose was to describe survival
  
  
  METHODS
  All women with primary invasive BC, diagnosed from 1998 to 2009 in the department of Côte d'Or were retrospectively selected using data from the Côte d'Or BC registry. European transnational ecological deprivation index (French European Deprivation Index) was used to measure the socio-economic environment. Relationships between socio-geographic deprivation and disease stage at diagnosis according to age were assessed by a multilevel ordered logistic regression model. Relative survival rates (RSRs) were given at 5 years according to tumour and patients characteristics.
  
  
  RESULTS
  In total, 4364 women were included. In multivariable analysis, socio-economic deprivation was associated with disease stage at diagnosis. Women aged between 50 and 74 years and living in deprived areas were more often diagnosed with advanced tumour stages (stages II/III vs. I or stages IV vs. II/III) with odds ratio = 1.27 (1.01-1.60). RSRs were lowest in women living in the most deprived area compared with those living in most affluent area with RSR = 88.4% (85.9-90.4) and 92.6% (90.5-94.2), respectively.
  
  
  CONCLUSIONS
  Socio-economic factors affected tumour stage at diagnosis and survival. Living in a deprived area was linked to advanced-stage BC at diagnosis only in women aged 50-74 years. This is probably due to the socio-economic disparities in participation in organized BC screening programmes. Furthermore, living in deprived area was associated with a poor survival rate.
authors.affiliation: 1 Breast and Gynaecologic Cancer Registry of Côte d'Or, Department of Medical Information Centre Georges François Leclerc comprehensive cancer centre, Dijon, France 2 EA 4184, Medical School University of Burgundy, Dijon, France odialla@cgfl.fr.
authors.forename: Pegdwende O
authors.initials: PO
authors.lastname: Dialla
authors.affiliation: 1 Breast and Gynaecologic Cancer Registry of Côte d'Or, Department of Medical Information Centre Georges François Leclerc comprehensive cancer centre, Dijon, France 2 EA 4184, Medical School University of Burgundy, Dijon, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Arveux
authors.affiliation: 1 Breast and Gynaecologic Cancer Registry of Côte d'Or, Department of Medical Information Centre Georges François Leclerc comprehensive cancer centre, Dijon, France 2 EA 4184, Medical School University of Burgundy, Dijon, France.
authors.forename: Samiratou
authors.initials: S
authors.lastname: Ouedraogo
authors.affiliation: 3 Department of Epidemiological Research and Evaluation, CHU de Caen, France 4 EA3936, Medical School, Université de Caen Basse-Normandie, Caen, France 5 U1086 Inserm, Cancers and Preventions, Medical School, Université de Caen Basse-Normandie, Avenue de la Côte de Nacre, Caen, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Pornet
authors.affiliation: 1 Breast and Gynaecologic Cancer Registry of Côte d'Or, Department of Medical Information Centre Georges François Leclerc comprehensive cancer centre, Dijon, France 2 EA 4184, Medical School University of Burgundy, Dijon, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Bertaut
authors.affiliation: 6 Pathology Centre, Dijon, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Roignot
authors.affiliation: 7 Radiotherapy and Oncology Centre of Park, Dijon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Janoray
authors.affiliation: 1 Breast and Gynaecologic Cancer Registry of Côte d'Or, Department of Medical Information Centre Georges François Leclerc comprehensive cancer centre, Dijon, France 2 EA 4184, Medical School University of Burgundy, Dijon, France.
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Poillot
authors.affiliation: 8 Coordination Unit in Geriatric oncology in Burgundy, Hôpital de jour Gériatrique, Hôpital de Champmaillot, Dijon, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Quipourt
authors.affiliation: 2 EA 4184, Medical School University of Burgundy, Dijon, France 9 Biostatistics and Quality of Life Unit, Department of Medical Information Centre Georges François Leclerc comprehensive cancer centre, Dijon, France.
authors.forename: Tienhan S
authors.initials: TS
authors.lastname: Dabakuyo-Yonli
mesh_terms: D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D011379:Prognosis; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012959:Socioeconomic Factors