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11-09-2023 | Breast Cancer | Original Paper

Socioeconomic and geographic disparities of breast cancer incidence according to stage at diagnosis in France

Authors: Claire Delacôte, Juan Manuel Ariza, Solenne Delacour-Billon, Stéphanie Ayrault-Piault, Giulio Borghi, Katia Menanteau, Aurélie Bouron, Magali Métais, Anne Cowppli-Bony, Florence Molinié

Published in: Cancer Causes & Control | Issue 2/2024

Abstract

Purpose

Low socioeconomic background (SB) has been associated with lower breast cancer (BC) incidence and higher BC mortality. One explanation of this paradox is the higher frequency of advanced BC observed in deprived women. However, it is still unclear if SB affects similarly BC incidence. This study investigated the link between SB and early/advanced BC incidence from Loire-Atlantique/Vendee Cancer registry data (France).

Materials and methods

Fourteen thousand three hundred fifty three women living in the geographic area covered by the registry and diagnosed with a primary BC in 2008–2015 were included. SB was approached by a combination of two ecological indexes (French European Deprivation Index and urban/rural residence place). Mixed effects logistic and Poisson regressions were used, respectively, to estimate the odds of advanced (stage ≥ II) BC and the ratio of incidence rates of early (stage 0–I) and advanced BC according to SB, overall and by age group (< 50, 50–74, ≥ 75).

Results

Compared to women living in affluent-urban areas, women living in deprived-urban and deprived-rural areas had a higher proportion of advanced BC [respectively, OR = 1.11 (1.01–1.22), OR = 1.60 (1.25–2.06)] and lower overall (from − 6 to − 15%) and early (from − 9 to − 31%) BC incidences rates Advanced BC incidence rates were not influenced by SB. These patterns were similar in women under 75 years, especially in women living in deprived-rural areas. In the elderly, no association between SB and BC frequency/incidence rates by stage was found.

Conclusion

Although advanced BC was more frequent in women living in deprived and rural areas, SB did not influence advanced BC incidence. Therefore, differences observed in overall BC incidence according to SB were only due to higher incidence of early BC in affluent and urban areas. Future research should confirm these results in other French areas.

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Title: Socioeconomic and geographic disparities of breast cancer incidence according to stage at diagnosis in France
Authors: Claire Delacôte
Juan Manuel Ariza
Solenne Delacour-Billon
Stéphanie Ayrault-Piault
Giulio Borghi
Katia Menanteau
Aurélie Bouron
Magali Métais
Anne Cowppli-Bony
Florence Molinié
Publication date: 11-09-2023
Publisher: Springer International Publishing
Keywords: Breast Cancer
Breast Cancer
Published in: Cancer Causes & Control / Issue 2/2024
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI: https://doi.org/10.1007/s10552-023-01779-8

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