Breast conservation, mastectomy and axillary surgery in New South Wales women in 1992 and 1995

Kricker, Anne; Haskill, J. S.; Armstrong, Bruce K.

doi:10.1054/bjoc.2001.1932

Cited by 18 publications

(31 citation statements)

References 18 publications

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“…Inequalities in access to cardiovascular healthcare have also been reported 3 . Furthermore, living in a rural area in Australia has been shown to affect cancer treatment patterns, 4 , 5 and being treated in a rural hospital has been shown to worsen patient outcomes 4 , 5 . The finding of a lower total procedure rate in the Indigenous population 1 , 2 is consistent with these findings.…”

mentioning

confidence: 55%

Treatment patterns for cancer in Western Australia: does being Indigenous make a difference?

Hall

Bulsara

et al. 2004

Medical Journal of Australia

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Objective: To examine whether hospital patients with cancer who were identified as Indigenous were as likely to receive surgery for the cancer as non‐Indigenous patients. Design, setting and patients: Epidemiological survey of all Western Australian (WA) patients who had a cancer registration in the state‐based WA Record Linkage Project that mentioned cancer of the breast (1982–2000) or cancer of the lung or prostate (1982–2001). Main outcome measures: The likelihoods of receiving breast‐conserving surgery or mastectomy for breast cancer, lung surgery for lung cancer, or radical or non‐radical prostatectomy for prostate cancer were compared between the Indigenous and non‐Indigenous populations using adjusted logistic regression analyses. Results: Indigenous people were less likely to receive surgery for their lung cancer (odds ratio [OR], 0.64; 95% CI, 0.41–0.98). Indigenous men were as likely as non‐Indigenous men to receive non‐radical prostatectomy (OR, 0.69; 95% CI, 0.40–1.17); only one Indigenous man out of 64 received radical prostatectomy. Indigenous women were as likely as non‐Indigenous women to undergo breast‐conserving surgery (OR, 0.86; 95% CI, 0.60–1.21). Conclusions: These results indicate a different pattern of surgical care for Indigenous patients in relation to lung and prostate, but not breast, cancer. Reasons for these disparities, such as treatment choice and barriers to care, require further investigation.

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confidence: 55%

Treatment patterns for cancer in Western Australia: does being Indigenous make a difference?

Hall

Bulsara

et al. 2004

Medical Journal of Australia

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“…It is probably in this group that quality of treatment would have the greatest effect. Remoteness may affect treatment choices made by both patients and clinicians, 18 , 19 and this might also affect survival.…”

Section: Discussionmentioning

confidence: 99%

Remoteness of residence and survival from cancer in New South Wales

Jong

Smith

et al. 2004

Medical Journal of Australia

160

176

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Objective: To analyse cancer survival in New South Wales by geographic remoteness. Design, setting and participants: A survival analysis of all patients with cancers diagnosed in NSW between 1 January 1992 and 31 December 1996. Survival was determined to 31 December 1999. Main outcome measures: The relative excess risk (RER) of death over 5 years was estimated for each geographic remoteness category relative to the highly accessible category for 20 cancer types adjusted for age, sex, years since diagnosis and, subsequently, stage of cancer at diagnosis. Results: There were statistically significant differences in the RER of death across remoteness categories (P < 0.001) for cancers of the cervix and prostate and for all cancers. The RERs for the most remote categories (compared with the highly accessible category) before and after adjustment for stage were cervix, 3.22 (95% CI, 1.54–6.75) and 2.25 (95% CI, 1.06–4.77); prostate, 3.38 (95% CI, 2.21–5.16) and 2.53 (95% CI, 1.60–4.01); all cancers, 1.35 (95% CI, 1.20–1.51) and 1.25 (95% CI, 1.11–1.41). In addition, there were significant variations in RER of death by remoteness for head and neck, lung and colon cancers and cutaneous melanoma. Conclusion: Cancer survival varies by remoteness of residence in NSW for all cancers together and some cancers individually. Access to screening or early diagnosis probably contributes to this variation, but persistence after adjustment for stage suggests that treatment variation is also important.

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“…In Be zug auf das Mam ma kar zi nom haben sich vie le Stu di en sei ner Ver brei tung und Ver sor gungs va ria bi li tät ge wid met: Stu di en aus den USA, Ita li en und Aust rali en zeig ten bei spiels wei se, dass Pa ti en tinnen in ge rin ge rem Maße brus ter hal tend ope riert wur den, wenn sie in länd li chen im Ver gleich zu städ ti schen Kran ken häu-sern, öf fent li chen im Ver gleich zu pri va ten, Nicht-Lehr-im Ver gleich zu Lehr kran kenhäu sern be han delt wur den [6,7,8,9]. Als eben so kon sis tent er wies sich ein nied ri ger so zio öko no mi scher Sta tus als Prä dik tor für eine ge rin ge re Rate brus ter hal ten der Ope ratio nen, zum Teil in Kom bi na ti on mit dem Fak tor eth ni sche Zu ge hö rig keit [10,11,12].…”

Section: Va Ri a Bi LI Tät Der Ver Sor Gungunclassified

Versorgungsforschung in der operativen Medizin am Beispiel der Mammakarzinomchirurgie

Geraedts

2006

Bundesgesundheitsbl - Gesundheitsforsch - Gesundheitsschutz

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The epidemiological relevance of breast cancer in Germany has led to a number of initiatives actually changing the processes and structures of care. The ultimate aim of health services research in surgery is to evaluate the impact of these initiatives on the effectiveness and efficiency of the respective health care services. Results of international studies show for instance breast-conserving therapy to be related to the patients' socioeconomic status. In addition, breast specialists tend to operate more in adherence to practice guidelines and to implement new procedures like sentinel lymph node biopsies earlier. Preliminary results from Germany also demonstrate a considerable practice variation in breast cancer surgery. Causes and effects of such variation still have to be explored. For that purpose, newly available data sources on health care services in relation to breast cancer surgery in Germany could be used. The inherent challenge is to combine data from tumour registries, statutory comparative quality assurance activities and inpatient remuneration via DRGs for health services research in surgery.

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Breast conservation, mastectomy and axillary surgery in New South Wales women in 1992 and 1995

Cited by 18 publications

References 18 publications

Treatment patterns for cancer in Western Australia: does being Indigenous make a difference?

Treatment patterns for cancer in Western Australia: does being Indigenous make a difference?

Remoteness of residence and survival from cancer in New South Wales

Versorgungsforschung in der operativen Medizin am Beispiel der Mammakarzinomchirurgie

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