dc.contributor.author |
Seneviratne, Sanjeewa |
en |
dc.contributor.author |
Campbell, Ian |
en |
dc.contributor.author |
Scott, Katrina |
en |
dc.contributor.author |
Lawrenson, Ross |
en |
dc.date.accessioned |
2018-10-15T22:43:31Z |
en |
dc.date.issued |
2017-01-21 |
en |
dc.identifier.citation |
BMC health services research 17(1):64 21 Jan 2017 |
en |
dc.identifier.issn |
1472-6963 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/41858 |
en |
dc.description.abstract |
Ethnic and socioeconomic inequities in use of breast cancer adjuvant therapy are well documented in many countries including the USA, and are known to contribute to lower breast cancer survival among minority ethnic and socioeconomically deprived women. We investigated ethnic and socioeconomic inequities in use of adjuvant radiotherapy and chemotherapy in a cohort of women with invasive breast cancer in New Zealand.All women with newly diagnosed invasive breast cancer during 1999-2012 were identified from the Waikato Breast Cancer Register. Rates of chemotherapy use and radiotherapy use were assessed in women who were deemed to be eligible for chemotherapy (n = 1212) and radiotherapy (n = 1708) based on guidelines. Factors associated with use of chemotherapy and radiation therapy were analysed in univariate and multivariate regression models, adjusting for covariates.Overall, rates of chemotherapy and radiotherapy use were 69% (n = 836) and 87.3% (n = 1491), respectively. In the multivariate model, significantly lower rates of radiotherapy use were associated with Māori compared with NZ European (Odds Ratio [OR] = 0.63, 0.40-0.98), presence of comorbidity (OR = 0.49, 0.34-0.72), distance from hospital of over 100km (OR = 0.47, 0.23-0.96), mastectomy compared with breast conserving surgery (OR = 0.32, 0.17-0.56) and non-screen compared with screen detection (OR = 0.53, 0.35-0.79). No significant associations were observed between chemotherapy use and ethnic or socio-demographic factors.Improving access for radiotherapy, especially for women who are at a higher risk of not receiving optimum cancer therapy due to ethnicity, geography or socioeconomic status need to be recognized as a priority to reduce inequities in breast cancer care in New Zealand. |
en |
dc.format.medium |
Electronic |
en |
dc.language |
eng |
en |
dc.relation.ispartofseries |
BMC health services research |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.rights.uri |
https://creativecommons.org/licenses/by/4.0/ |
en |
dc.subject |
Humans |
en |
dc.subject |
Breast Neoplasms |
en |
dc.subject |
Combined Modality Therapy |
en |
dc.subject |
Chemotherapy, Adjuvant |
en |
dc.subject |
Radiotherapy, Adjuvant |
en |
dc.subject |
Mastectomy |
en |
dc.subject |
Risk |
en |
dc.subject |
Cohort Studies |
en |
dc.subject |
Comorbidity |
en |
dc.subject |
Social Class |
en |
dc.subject |
Adult |
en |
dc.subject |
Aged |
en |
dc.subject |
Middle Aged |
en |
dc.subject |
Ethnic Groups |
en |
dc.subject |
New Zealand |
en |
dc.subject |
Female |
en |
dc.subject |
Healthcare Disparities |
en |
dc.title |
A cohort study of ethnic differences in use of adjuvant chemotherapy and radiation therapy for breast cancer in New Zealand. |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1186/s12913-017-2027-4 |
en |
pubs.issue |
1 |
en |
pubs.begin-page |
64 |
en |
pubs.volume |
17 |
en |
dc.rights.holder |
Copyright: The authors |
en |
dc.identifier.pmid |
28109301 |
en |
pubs.publication-status |
Published |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/OpenAccess |
en |
pubs.subtype |
Comparative Study |
en |
pubs.subtype |
Research Support, Non-U.S. Gov't |
en |
pubs.subtype |
research-article |
en |
pubs.subtype |
Journal Article |
en |
pubs.elements-id |
701852 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
School of Medicine |
en |
pubs.org-id |
Surgery Department |
en |
dc.identifier.eissn |
1472-6963 |
en |
pubs.record-created-at-source-date |
2017-01-23 |
en |
pubs.dimensions-id |
28109301 |
en |