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. 2023 Jan;128(1):63-70.
doi: 10.1038/s41416-022-02024-w. Epub 2022 Nov 1.

Is survival rate lower after breast cancer in deprived women according to disease stage?

Claire Delacôte  1   2   3 , Solenne Delacour-Billon  4   5 , Stéphanie Ayrault-Piault  4   5 , Anne-Delphine Tagri  4 , Gwenaëlle Rousseau  4 , Mélissa Vincent  4 , Sophie Amossé  4 , Cyrille Delpierre  6 , Anne Cowppli-Bony  4   7   8   5   6 , Florence Molinié  4   7   8   5   6
Affiliations

Is survival rate lower after breast cancer in deprived women according to disease stage?

Claire Delacôte et al. Br J Cancer. 2023 Jan.

Abstract

Background: Socioeconomic deprivation has been associated with lower breast cancer (BC) survival, but the influence of stage at diagnosis on this association merits further study. Our aim was to investigate this association using the Loire-Atlantique/Vendee Cancer Registry (France).

Methods: Twelve-thousand seven-hundred thirty-eight women living in the area covered by the registry and diagnosed with invasive breast carcinoma between 2008 and 2015 were included in the study. They were censored at maximal 6 years. Deprivation was measured by the French European Deprivation Index. Excess hazard and net survival were estimated for deprivation level, stage and age at diagnosis using a flexible excess mortality hazard model.

Results: After adjustment by stage, women living in the most deprived areas had a borderline non-significant higher excess mortality hazard (+25% (95% CI: -3%; +62%)) compared to those living in the least deprived areas. Stage-adjusted 5-year net survival differed significantly between these two subgroups (respectively, 88.2% (95% CI:85.2%-90.5%) and 92.5% (95% CI:90.6%-93.9%)).

Conclusion: BC survival remained lower in deprived areas in France, despite universal access to cancer care. Intensification of prevention measures could help to reduce advanced BC, responsible for the majority of deaths from BC. A better understanding of remaining social disparities is crucial to implement specific interventions.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart.
Fig. 2
Fig. 2
Adjusted excess mortality hazard and their 95% confidence interval according to stage atdiagnosis for the extreme deprivation quintiles (Q1, Q5) for the 12,738 women with breast carcinoma diagnosed in 2008–2015, living in Loire-Atlantique or Vendee at diagnosis, overall and by different ages at diagnosis.
Fig. 3
Fig. 3
Adjusted net survival and their 95% confidence interval for the 12,738 women with breastcarcinoma diagnosed between in 2008–2015 and living in Loire-Atlantique or Vendee according todeprivation quintiles and by stage at diagnosis.
See this image and copyright information in PMC

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