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dc.contributor.authorWalsh, Paul M.
dc.contributor.authorByrne, Julianne
dc.contributor.authorKelly, Maria
dc.contributor.authorMcDevitt, Joe
dc.contributor.authorComber, Harry
dc.contributor.authorMetze, Konradin
dc.date.accessioned2014-11-26T12:52:10Z
dc.date.available2014-11-26T12:52:10Z
dc.date.issued2014-11-05
dc.identifier.citationWalsh, P.M. et al., 2014. Socioeconomic disparity in survival after breast cancer in Ireland: observational study. PLoS ONE, 9 (11):e111729 [published online 05 November 2014]en_GB
dc.identifier.issn1932-6203
dc.identifier.doi10.1371/journal.pone.0111729
dc.identifier.urihttp://hdl.handle.net/10147/336176
dc.descriptionWe evaluated the relationship between breast cancer survival and deprivation using data from the Irish National Cancer Registry. Cause-specific survival was compared between five area-based socioeconomic deprivation strata using Cox regression. Patient and tumour characteristics and treatment were compared using modified Poisson regression with robust variance estimation. Based on 21356 patients diagnosed 1999–2008, age-standardized five-year survival averaged 80% in the least deprived and 75% in the most deprived stratum. Age-adjusted mortality risk was 33% higher in the most deprived group (hazard ratio 1.33, 95% CI 1.21–1.45, P<0.001). The most deprived groups were more likely to present with advanced stage, high grade or hormone receptor-negative cancer, symptomatically, or with significant comorbidity, and to be smokers or unmarried, and less likely to have breast-conserving surgery. Cox modelling suggested that the available data on patient, tumour and treatment factors could account for only about half of the survival disparity (adjusted hazard ratio 1.18, 95% CI 0.97–1.43, P = 0.093). Survival disparity did not diminish over time, compared with the period 1994–1998. Persistent survival disparities among Irish breast cancer patients suggest unequal use of or access to services and highlight the need for further research to understand and remove the behavioural or other barriers involved.en_GB
dc.language.isoenen
dc.relation.urlhttp://dx.plos.org/10.1371/journal.pone.0111729en_GB
dc.rightsArchived with thanks to PLoS ONEen_GB
dc.subjectBREAST CANCERen_GB
dc.subjectSOCIAL FACTORen_GB
dc.titleSocioeconomic disparity in survival after breast cancer in Ireland: observational studyen_GB
dc.typeArticleen
dc.identifier.journalPLoS ONEen_GB
refterms.dateFOA2018-08-24T21:37:39Z


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