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. 2019 Feb 1;9(2):e026414.
doi: 10.1136/bmjopen-2018-026414.

Metastatic breast cancer incidence, site and survival in Australia, 2001-2016: a population-based health record linkage study protocol

Sarah J Lord  1   2 , Belinda E Kiely  2 , Sallie-Anne Pearson  3 , Benjamin Daniels  3 , Dianne L O'Connell  4   5   6 , Jane Beith  7 , Max K Bulsara  8 , Nehmat Houssami  5
Affiliations

Metastatic breast cancer incidence, site and survival in Australia, 2001-2016: a population-based health record linkage study protocol

Sarah J Lord et al. BMJ Open. .

Abstract

Introduction: Advances in systemic therapy for early and metastatic breast cancer (BC) over the last two decades have improved patients' survival, but their impact on metastatic disease outcomes at a population level is not well described. The aim of this study is to investigate changes in the incidence, site and survival of metastatic disease for women with a first diagnosis of BC in 2001-2002 vs 2006-2007.

Methods and analysis: Population-based retrospective cohort study of women with first primary invasive BC registered in the New South Wales (NSW) Cancer Registry in 2001-2002 and 2006-2007. We will use linked records from NSW hospitals, dispensed medicines, outpatient services and death registrations to determine: women's demographic and tumour characteristics; treatments received; time to first distant metastasis; site of first metastasis and survival. We will use the Kaplan-Meier method to estimate cumulative incidence of distant metastasis, distant recurrence-free interval and postmetastasis survival by extent of disease at initial diagnosis, site of metastasis and treatment-defined tumour receptor type (hormone receptor-positive, human epidermal growth factor receptor-2-positive, triple negative). We will use Cox proportional hazards regression to estimate the relative effects of prognostic factors, and we will compare systemic therapy patterns by area-of-residence and area-level socioeconomic status to examine equity of access to healthcare.

Ethics and dissemination: Research ethics committee approval was granted by the Australian Institute of Health and Welfare (#EO2017/2/255), NSW Population and Health Services (#HREC/17/CIPHS/19) and University of Notre Dame Australia (#0 17 144S). We will disseminate research findings to oncology, BC consumer and epidemiology audiences through national and international conference presentations, lay summaries to BC consumer groups and publications in international peer-reviewed oncology and cancer epidemiology journals.

Keywords: breast tumours; distant recurrence-free interval; epidemiology; health record linkage; metastatic breast cancer; prognosis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Study schema.
See this image and copyright information in PMC

References

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