- Volume 14 Issue 1
DOI QR Code
Risk Factors for Poorer Breast Cancer Outcomes in Residents of Remote Areas of Australia
- Roder, David (Cancer Australia) ;
- Zorbas, Helen (Cancer Australia) ;
- Kollias, James (National Breast Cancer Audit Steering Committee) ;
- Pyke, Chris (Breast Surgeons of Australia and New Zealand) ;
- Walters, David (Breast Surgeons of Australia and New Zealand) ;
- Campbell, Ian (Waikato Clinical School, University of Auckland, Faculty of Medical and Health Sciences) ;
- Taylor, Corey (National Breast Cancer Audit, Royal Australasian College of Surgeons) ;
- Webster, Fleur (Breast Cancer, Cancer Australia)
- Published : 2013.01.31
To investigate patient, cancer and treatment characteristics in females with breast cancer from more remote areas of Australia, to better understand reasons for their poorer outcomes, bi-variable and multivariable analyses were undertaken using the National Breast Cancer Audit database of the Society of Breast Surgeons of Australia and New Zealand. Results indicated that patients from more remote areas were more likely to be of lower socio-economic status and be treated in earlier diagnostic epochs and at inner regional and remote rather than major city centres. They were also more likely to be treated by low case load surgeons, although this finding was only of marginal statistical significance in multivariable analysis (p=0.074). Patients from more remote areas were less likely than those from major cities to be treated by breast conserving surgery, as opposed to mastectomy, and less likely to have adjuvant radiotherapy when having breast conserving surgery. They had a higher rate of adjuvant chemotherapy. Further monitoring will be important to determine whether breast conserving surgery and adjuvant radiotherapy utilization increase in rural patients following the introduction of regional cancer centres recently funded to improve service access in these areas.
- Australian Government, Department of Health and Ageing (2009). Screening Monograph No. 5/2009. BreastScreen Evaluation - participation and performance trends. Canberra: Commonwealth of Australia.
- Australian Institute of Health and Welfare (AIHW), Australasian Association of Cancer Registries (AACR) (2003) Cancer survival in Australia 1992-1997: geographic categories and socioeconomic status. Cancer Series no.22. Cat. No. CAN 17. Canberra: Australian Institute and Welfare.
- Australian Institute of Health and Welfare (AIHW), Cancer Australia (CA), Australasian Association of Cancer Registries (AACR) (2008). Cancer survival and prevalence in Australia: cancers diagnosed from 1982 to 2004. Cancer Series no. 42. Cat. No. CAN 38. Canberra: Australian Institute of Health and Welfare.
- Australian Institute of Health and Welfare (AIHW), Cancer Australia (CA) (2012). Breast cancer in Australia: an overview. Cancer Series no. 71. Cat. No. CAN 67. Canberra: Australian Institute and Welfare.
- Australian Institute of Health and Welfare (AIHW) (2012). Cancer survival and prevalence in Australia; period estimates from 1982-2010. Cancer Series no. 69. Cat. no. CAN 65. Canberra: Australian Institute of Health and Welfare.
- Australian Institute of Health and Welfare (AIHW), National Breast and Ovarian Cancer Centre (NBOCC) (2009). Breast cancer in Australia: an overview, 2009. Cancer Series no. 50. Cat. No. CAN 46. Canberra: Australian Institute and Welfare.
- Chong A, Roder D (2010). Exploring differences in survival from cancer among Indigenous and non-indigenous Australians: implications for health service delivery and research. Asian Pac J Cancer Prev, 11, 953-61.
- Marsh CJ, Boult M, Wang JX, et al (2008). National breast cancer audit. The use of multidisciplinary care teams by breast surgeons in Australia and New Zealand. MJA, 188, 385-8.
- Morrell S, Taylor R, Roder D, Dobson A (2012a). Mammography screening and breast cancer mortality in Australia: an aggregate cohort study. J Med Screen, 19, 26-34.
- Morrell S, You H, Baker D (2012b). Estimates of cancer incidence, mortality and survival in aboriginal people from NSW, Australia. BMC Cancer, 12, 1-16. https://doi.org/10.1186/1471-2407-12-1
- National Rural Health Alliance (1994). National Rural Health Strategy. Issued by Australian Health Ministers' Conference. Canberra: Australian Government Publishing Service.
- Nickson C, Mason KE, English DR, Kavanagh AM (2012). Mammographic screening and breast cancer mortality: a case-control study and meta-analysis. Cancer Epidemiol Biomarkers Prev, 21, 1479-88. https://doi.org/10.1158/1055-9965.EPI-12-0468
- Roder DM, de Silva P, Zorbas HM, et al (2012a). Age effects on survival from early breast cancer in clinical settings in Australia. ANZ J Surg, 82, 524-8. https://doi.org/10.1111/j.1445-2197.2012.06114.x
- Roder D, de Silva P, Zorbas HM, et al (2012b). Survival from breast cancer: an analysis of Australian data by surgeon case load, treatment centre location, and health insurance status. Aust Health Rev, 36, 342-8. https://doi.org/10.1071/AH11060
- Armitage P, Berry G (1987). Statistical methods in medical research. Oxford: Blackwell Scientific Publication.
- Australian Bureau of Statistics (ABS) (1998). 1996 census of population and housing. Socio-economic index for areas. Canberra: Australian Bureau of Statistics.
- Australian Health Ministers' Conference (2012). Standing Council on Health. National Strategic Framework for Rural and Remote Health. Canberra: Commonwealth of Australia.
- Australian Government, Department of Health and Ageing (2012). Health and Hospitals Fund. Canberra: Commonwealth of Australia.
- Roder D, Wang JX, Zorbas H, Kollias J, Maddern G (2010). Survival from breast cancers managed by surgeons participating in the National Breast Cancer Audit of the Royal Australasian College of Surgeons. ANZ J Surg, 80, 776-80. https://doi.org/10.1111/j.1445-2197.2010.05341.x
- Roder D, Zorbas H, Kollias J, et al (2013). Factors predictive of treatment by Australian breast surgeons of invasive female breast cancer by mastectomy rather than breast conserving surgery. Asian Pac J Cancer Prev (in press).
- Roder D, Houssami N, Farshid G, et al (2008). Population screening and intensity of screening are associated with reduced breast cancer mortality: evidence of efficacy of mammography screening in Australia. Breast Cancer Res Treat, 108, 409-16. https://doi.org/10.1007/s10549-007-9609-5
- Roder D, Zorbas H, Kollias J, et al (2012c). Factors predictive of immediate breast reconstruction following mastectomy for invasive breast cancer in Australia 1998-2010. Sydney: Cancer Australia and Society of Breast Surgeons of Australia and New Zealand.
- South Australian Cancer Registry (2000). Epidemiology of cancer in South Australia. Incidence, mortality and survival 1977 to 1999. Incidence and mortality 1999. Adelaide, Openbook Pub.
- StataCorp (2011). Stata Statistical Software. Release 12. College Station, Texas, StataCorp LP.
- Taylor R, Morrell S, Estoesta J, Brassil A (2004). Mammography screening and breast cancer mortality in New South Wales, Australia. Cancer Causes Control, 15, 543-50. https://doi.org/10.1023/B:CACO.0000036153.95908.f2
- Breast Cancer Screening Barriers from the Womans Perspective: a Meta-synthesis vol.16, pp.8, 2015, https://doi.org/10.7314/APJCP.2015.16.8.3463
- A systematic review of inequalities in psychosocial outcomes for women with breast cancer according to residential location and Indigenous status in Australia vol.25, pp.10, 2016, https://doi.org/10.1002/pon.4124
- Geographical Inequalities in Surgical Treatment for Localized Female Breast Cancer, Queensland, Australia 1997–2011: Improvements over Time but Inequalities Remain vol.13, pp.7, 2016, https://doi.org/10.3390/ijerph13070729
- Urban Rural Differences in Breast Cancer in New Zealand vol.13, pp.10, 2016, https://doi.org/10.3390/ijerph13101000
- An Exploration of Underrepresentation of Aboriginal Cancer Patients Attending a Regional Radiotherapy Service in Western Australia vol.15, pp.2, 2018, https://doi.org/10.3390/ijerph15020337
- Exploring treatment decision-making in cancer management for rural residents: Patient and provider perspectives on a recently established regional radiotherapy service vol.14, pp.5, 2018, https://doi.org/10.1111/ajco.12873
- Cancer support services: Are they meeting the needs of rural radiotherapy patients? pp.09615423, 2018, https://doi.org/10.1111/ecc.12904