title: Breast cancer survival and health iniquities.
abstract: Breast cancer is the most frequent neoplasm in women, and some studies have shown social inequalities in incidence and survival, which are poorly investigated in Brazil. To assess iniquity in prognosis, a hospital-based cohort study was carried out. Follow-up was made by active search in medical records and in the Mortality Information System, phone calls, and consultation on Individual Tax-Collection Record status. Survival functions were estimated by the Kaplan-Meier method, and the Cox proportional hazards model was employed for prognostic assessment. Disease-specific survival was estimated at 76.3% (95%CI: 71.9-81.0) in 5 years. Women seen at public facilities had worse prognosis (HR = 1.79; 95%CI: 1.09-2.94), which was particularly due to the disease being diagnosed at a more advanced stage. These findings point to inequalities of access to screening actions, as women of lower social conditions with later diagnostic and therefore with worse prognostic.
authors.affiliation: Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, BR.
authors.forename: Maximiliano Ribeiro
authors.initials: MR
authors.lastname: Guerra
authors.affiliation: Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, BR.
authors.forename: Gulnar Azevedo e
authors.initials: GA
authors.lastname: Silva
authors.affiliation: Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, BR.
authors.forename: Mário Círio
authors.initials: MC
authors.lastname: Nogueira
authors.affiliation: Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, BR.
authors.forename: Isabel Cristina Gonçalves
authors.initials: IC
authors.lastname: Leite
authors.affiliation: Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, BR.
authors.forename: Raquel de Vasconcellos Carvalhaes de
authors.initials: Rde V
authors.lastname: Oliveira
authors.affiliation: Instituto Oncológico, Hospital 9 de Julho, Juiz de Fora, BR.
authors.forename: Jane Rocha Duarte
authors.initials: JR
authors.lastname: Cintra
authors.affiliation: Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, BR.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Bustamante-Teixeira
mesh_terms: D001938:Brazil / Q000453:epidemiology; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012959:Socioeconomic Factors; D016019:Survival Analysis