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BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research Article

Geographic variation in the intended choice of adjuvant treatments for women diagnosed with screen-detected breast cancer in Queensland

Authors: Jeff Ching-Fu Hsieh, Susanna M. Cramb, James M. McGree, Nathan A. M. Dunn, Peter D. Baade, Kerrie L. Mengersen

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Although early diagnosis and improved treatment can reduce breast cancer mortality, there still appears to be a geographic differential in patient outcomes. This study aims to determine and quantify spatial inequalities in intended adjuvant (radio-, chemo- and hormonal) therapy usage among women with screen-detected breast cancer in Queensland, Australia.

Methods

Linked population-based datasets from BreastScreen Queensland and the Queensland Cancer Registry during 1997−2008 for women aged 40−89 years were used. We adopted a Bayesian shared spatial component model to evaluate the relative intended use of each adjuvant therapy across 478 areas as well as common spatial patterns between treatments.

Results

Women living closer to a cancer treatment facility were more likely to intend to use adjuvant therapy. This was particularly marked for radiotherapy when travel time to the closest radiation facility was 4 + h (OR =0.41, 95 % CrI: [0.23, 0.74]) compared to <1 h. The shared spatial effect increased towards the centres with concentrations of radiotherapy facilities, in north-east (Townsville) and south-east (Brisbane) regions of Queensland. Moreover, the presence of residual shared spatial effects indicates that there are other unmeasured geographical barriers influencing women’s treatment choices.

Conclusions

This highlights the need to identify the additional barriers that impact on treatment intentions among women diagnosed with screen-detected breast cancer, particularly for those women living further away from cancer treatment centers.
Appendix
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Metadata
Title
Geographic variation in the intended choice of adjuvant treatments for women diagnosed with screen-detected breast cancer in Queensland
Authors
Jeff Ching-Fu Hsieh
Susanna M. Cramb
James M. McGree
Nathan A. M. Dunn
Peter D. Baade
Kerrie L. Mengersen
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2527-2

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