Breast cancer survival and health iniquities

Detalhes bibliográficos
Autor(a) principal: Maximiliano Ribeiro Guerra
Data de Publicação: 2015
Outros Autores: 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
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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spelling 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
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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
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dc.format.none.fl_str_mv text/html
text/html
application/pdf
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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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