Beyond the urban-rural divide: Exploring spatial variations in breast cancer outcomes in Queensland, Australia.

Bayesian Breast cancer Early detection Geographic variation Incidence Screening Spatial analysis Survival Treatment

Journal

Cancer epidemiology
ISSN: 1877-783X
Titre abrégé: Cancer Epidemiol
Pays: Netherlands
ID NLM: 101508793

Informations de publication

Date de publication:
03 Oct 2024
Historique:
received: 12 06 2024
revised: 06 09 2024
accepted: 30 09 2024
medline: 5 10 2024
pubmed: 5 10 2024
entrez: 4 10 2024
Statut: aheadofprint

Résumé

Breast cancer is the most commonly diagnosed cancer among women worldwide. While previous studies have reported urban and rural differences in breast cancer outcomes, the level of heterogeneity within these broad regions is currently unknown. Population-level data from Queensland Cancer Register including 58,679 women aged at least 20 years who were diagnosed with breast cancer in Queensland, Australia, 2000-2019 were linked to BreastScreen Queensland and Queensland Hospital Admitted Patients Data Collection to estimate five breast cancer outcomes: incidence, proportion of localised disease and screen-detected cases (via public-funded program), surgical rates, and 5-year survival. Bayesian spatial models were used to smooth outcomes across 512-517 small areas in Queensland. The incidence of breast cancer was not proportionally distributed, with urban regions having higher rates. Less than half (47 %) of women were diagnosed with localised disease, 91 % had surgery, with five-year relative survival of 92 %. There was no evidence of geographic variation in the proportion of localised disease, surgical rates, or survival over Queensland. Publicly-funded screening detected 38 % of cases, with lower proportion of screen-detected cases observed in Queensland's urbanised south-east corner. Although the disparities in health outcomes faced by Australians living in rural areas have received increased attention, this study found limited evidence for spatial variation in breast cancer outcomes along the continuum of care across Queensland. These results suggest the detection and management practices for breast cancer may provide an achievable benchmark for other cancer types in reducing the geographical disparity in cancer outcomes.

Sections du résumé

BACKGROUND BACKGROUND
Breast cancer is the most commonly diagnosed cancer among women worldwide. While previous studies have reported urban and rural differences in breast cancer outcomes, the level of heterogeneity within these broad regions is currently unknown.
METHODS METHODS
Population-level data from Queensland Cancer Register including 58,679 women aged at least 20 years who were diagnosed with breast cancer in Queensland, Australia, 2000-2019 were linked to BreastScreen Queensland and Queensland Hospital Admitted Patients Data Collection to estimate five breast cancer outcomes: incidence, proportion of localised disease and screen-detected cases (via public-funded program), surgical rates, and 5-year survival. Bayesian spatial models were used to smooth outcomes across 512-517 small areas in Queensland.
RESULTS RESULTS
The incidence of breast cancer was not proportionally distributed, with urban regions having higher rates. Less than half (47 %) of women were diagnosed with localised disease, 91 % had surgery, with five-year relative survival of 92 %. There was no evidence of geographic variation in the proportion of localised disease, surgical rates, or survival over Queensland. Publicly-funded screening detected 38 % of cases, with lower proportion of screen-detected cases observed in Queensland's urbanised south-east corner.
CONCLUSION CONCLUSIONS
Although the disparities in health outcomes faced by Australians living in rural areas have received increased attention, this study found limited evidence for spatial variation in breast cancer outcomes along the continuum of care across Queensland. These results suggest the detection and management practices for breast cancer may provide an achievable benchmark for other cancer types in reducing the geographical disparity in cancer outcomes.

Identifiants

DOI: 10.1016/j.canep.2024.102681 PMID: 39366328
pubmed: 39366328
pii: S1877-7821(24)00160-7
doi: 10.1016/j.canep.2024.102681
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102681

Informations de copyright

Copyright © 2024 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Kou Kou (K)

Cancer Council Queensland, Brisbane, Australia; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.

Jessica Cameron (J)

Cancer Council Queensland, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia; Centre for Data Science, Faculty of Science, Queensland University of Technology, Brisbane, Australia.

Paramita Dasgupta (P)

Cancer Council Queensland, Brisbane, Australia.

Aiden Price (A)

Centre for Data Science, Faculty of Science, Queensland University of Technology, Brisbane, Australia.

Hao Chen (H)

Australian Urban Research Infrastructure Network, Melbourne, Australia.

Derrick Lopez (D)

School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia.

Kerrie Mengersen (K)

Centre for Data Science, Faculty of Science, Queensland University of Technology, Brisbane, Australia.

Sandi Hayes (S)

Cancer Council Queensland, Brisbane, Australia; School of Health Sciences and Social Work, Griffith University, Brisbane, Australia.

Peter Baade (P)

Cancer Council Queensland, Brisbane, Australia; Centre for Data Science, Faculty of Science, Queensland University of Technology, Brisbane, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Parklands Drive, Southport, QLD, Australia. Electronic address: peter.baade@qut.edu.au.

Classifications MeSH