Breast cancer survival and health iniquities
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng por |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5911 |
Resumo: | 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. |
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Breast cancer survival and health iniquitiesSobrevida por câncer de mama e iniquidade em saúdeBreast NeoplasmsPrognosisSurvival AnalysisEquityNeoplasias da MamaPrognósticoAnálise de SobrevidaEquidadeBreast 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.Algunos estudios muestran desigualdades sociales en la incidencia y la supervivencia del cáncer de mama, lo que se ha estudiado poco en Brasil. Para evaluar la inequidad en el pronóstico del cáncer de mama, se realizó un estudio de cohorte de base hospitalaria. El seguimiento de los pacientes se llevó a cabo por medio de una búsqueda activa en los registros médicos y en el Sistema Nacional de Mortalidad brasileño; llamadas de teléfono y búsqueda de números de identificación nacionales. Las funciones de supervivencia fueron estimadas por el método de Kaplan-Meier y el modelo de riesgos proporcionales de Cox se utilizó para la evaluación pronóstica. La supervivencia específica del cáncer de mama en cinco años fue de un 76,3% (IC95%: 71,9-81,0). Las mujeres que recibieron asistencia en los servicios públicos tenían peor pronóstico (HR = 1,79; IC95%: 1,09 a 2,94), y este efecto fue medido principalmente por el estadio de la enfermedad más avanzada en el momento del diagnóstico. Estos resultados apuntan a la existencia de desigualdades en el acceso a las acciones de detección del cáncer de mama.O câncer de mama é a neoplasia mais frequente em mulheres e alguns estudos mostram desigualdades sociais na sua incidência e sobrevida, o que é pouco estudado no Brasil. Para avaliar a iniquidade no seu prognóstico, foi feito estudo de coorte hospitalar. O seguimento foi realizado por busca ativa nos registros médicos e Sistema de Informação sobre Mortalidade, contato telefônico e consulta de situação cadastral no Cadastro de Pessoas Físicas. As funções de sobrevida foram estimadas pelo método de Kaplan-Meier e o modelo de riscos proporcionais de Cox foi utilizado para avaliação prognóstica. Foi estimada uma sobrevida específica pela doença de 76,3% (IC95%: 71,9-81,0) em 5 anos. As mulheres atendidas no serviço público tiveram pior prognóstico (HR = 1,79; IC95%: 1,09-2,94), e tal efeito foi mediado, sobretudo, pelo estadiamento da doença mais avançado no momento do diagnóstico. Tais achados apontam para a existência de desigualdades de acesso a ações de rastreamento, com as mulheres de menor posição socioeconômica tendo diagnóstico mais tardio e consequentemente pior prognóstico.Reports in Public HealthCadernos de Saúde Pública2015-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmltext/htmlapplication/pdfapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5911Reports in Public Health; Vol. 31 No. 8 (2015): AugustCadernos de Saúde Pública; v. 31 n. 8 (2015): Agosto1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZengporhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5911/12385https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5911/12386https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5911/12387https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5911/12388Maximiliano Ribeiro GuerraGulnar Azevedo e SilvaMário Círio NogueiraIsabel Cristina Gonçalves LeiteRaquel de Vasconcellos Carvalhaes de OliveiraJane Rocha Duarte CintraMaria Teresa Bustamante-Teixeirainfo:eu-repo/semantics/openAccess2024-03-06T15:29:01Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/5911Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:06:46.119780Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
Breast cancer survival and health iniquities Sobrevida por câncer de mama e iniquidade em saúde |
title |
Breast cancer survival and health iniquities |
spellingShingle |
Breast cancer survival and health iniquities Maximiliano Ribeiro Guerra Breast Neoplasms Prognosis Survival Analysis Equity Neoplasias da Mama Prognóstico Análise de Sobrevida Equidade |
title_short |
Breast cancer survival and health iniquities |
title_full |
Breast cancer survival and health iniquities |
title_fullStr |
Breast cancer survival and health iniquities |
title_full_unstemmed |
Breast cancer survival and health iniquities |
title_sort |
Breast cancer survival and health iniquities |
author |
Maximiliano Ribeiro Guerra |
author_facet |
Maximiliano Ribeiro Guerra Gulnar Azevedo e Silva Mário Círio Nogueira Isabel Cristina Gonçalves Leite Raquel de Vasconcellos Carvalhaes de Oliveira Jane Rocha Duarte Cintra Maria Teresa Bustamante-Teixeira |
author_role |
author |
author2 |
Gulnar Azevedo e Silva Mário Círio Nogueira Isabel Cristina Gonçalves Leite Raquel de Vasconcellos Carvalhaes de Oliveira Jane Rocha Duarte Cintra Maria Teresa Bustamante-Teixeira |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Maximiliano Ribeiro Guerra Gulnar Azevedo e Silva Mário Círio Nogueira Isabel Cristina Gonçalves Leite Raquel de Vasconcellos Carvalhaes de Oliveira Jane Rocha Duarte Cintra Maria Teresa Bustamante-Teixeira |
dc.subject.por.fl_str_mv |
Breast Neoplasms Prognosis Survival Analysis Equity Neoplasias da Mama Prognóstico Análise de Sobrevida Equidade |
topic |
Breast Neoplasms Prognosis Survival Analysis Equity Neoplasias da Mama Prognóstico Análise de Sobrevida Equidade |
description |
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. |
publishDate |
2015 |
dc.date.none.fl_str_mv |
2015-08-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5911 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5911 |
dc.language.iso.fl_str_mv |
eng por |
language |
eng por |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5911/12385 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5911/12386 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5911/12387 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5911/12388 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html text/html application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 31 No. 8 (2015): August Cadernos de Saúde Pública; v. 31 n. 8 (2015): Agosto 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
collection |
Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
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1816705371794833408 |