Treatment delay for Māori women with breast cancer in New Zealand

Seneviratne, Sanjeewa; Campbell, Ian; Scott, Nina; Coles, Clare; Lawrenson, Ross

doi:10.1080/13557858.2014.895976

Cited by 38 publications

(39 citation statements)

References 31 publications

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“…Além disso, outro estudo constatou que mulheres com mais de 80 anos iniciavam tratamento mais precocemente que mulheres mais jovens 28 . Na Nova Zelândia, um estudo mostrou que o atraso foi maior para as mulheres em faixa etária menor que 50 anos e maior que 70 anos 32 .…”

Section: Resultsunclassified

“…Esse estudo concluiu que em grupos minoritários o atraso é maior do que em mulheres brancas, e que a morosidade na realização do diagnóstico e do tratamento das mulheres negras norte-americanas demonstrou a fragilidade do sistema de saúde dos Estados Unidos em prestar assistência adequada a esse grupo, desde a detecção do câncer até o tratamento paliativo 28 . Autores neozelandeses corroboraram a afirmativa de que há disparidade no acesso aos serviços de saúde para grupos minoritários, concluindo que as populações nativas do país compostas por mulheres Maori (37,1 dias) e do Pacífico (42,8 dias) foram submetidas à cirurgia primária mais tardiamente que as mulheres de origem europeia (30,4 dias) 32 . Resultado semelhante foi compartilhado por outros pesquisadores 18,21,27,29,34 .…”

Section: Resultsunclassified

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Análise dos determinantes que influenciam o tempo para o início do tratamento de mulheres com câncer de mama no Brasil

et al. 2015

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Section: Resultsunclassified

Análise dos determinantes que influenciam o tempo para o início do tratamento de mulheres com câncer de mama no Brasil

et al. 2015

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“…Although publicly funded screening and treatment services are available nationwide in New Zealand, there is some evidence of differential access or quality of care by screen-detection status and ethnic group. Surgery delays have been reported as more common in non-BSA diagnosed women and among Māori, and surgery delay in the public sector was also found to be more likely than in the private sector (Seneviratne et al , 2015; Lawrenson et al , 2016). Māori women have also been observed as less likely to have radiotherapy and/or adhere to long-term adjuvant endocrine therapy, and more likely to have a mastectomy, than non-Māori women (Lawrenson et al , 2016).…”

Section: Discussionmentioning

confidence: 99%

Mammography service screening and breast cancer mortality in New Zealand: a National Cohort Study 1999–2011

et al. 2017

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Background:This breast cancer mortality evaluation of service screening mammography in New Zealand, the first since commencement of screening in 1999, applies to the 1999–2011 diagnostic period. Individual-level linked information on mammography screening, breast cancer diagnosis and breast cancer mortality is used to analyse differences in breast cancer mortality according to participation in organised screening mammography, as provided by BreastScreen Aotearoa (BSA).Methods:Women were followed from the time they became eligible for screening, from age 50 years (1999–2004) and 45 years (⩾2004). Breast cancer mortality from cancers diagnosed during the screening period from 1999 to 2011 (n=4384) is examined in relation to individual screening participation or non-participation during preceding person-years of follow-up from the time of screening eligibility. To account for changes from never- to ever-screened status, breast cancer mortality is calculated for each year in relation to prior accumulated time of participation and non-participation in screening. Breast cancer mortality is also examined in regularly screened women (screened ⩾3 times and mean screening interval ⩽30 months), and irregularly screened women compared with never-screened women. Statistical analyses are by negative binomial and Poisson regression with adjustment for age and ethnic group (Māori, Pacific women) in a repeated-measures analysis. Relative risks for breast cancer mortality compared with never-screened women, are adjusted also for screening selection bias, to indicate the extent of breast cancer mortality reduction in a population offered and not offered mammography screening. Prognostic indicators at diagnosis of breast cancer are also compared between different screening participation groups, including by grade of tumour, extent of disease (spread), multiple tumour status and maximum tumour size using χ2 statistics, t-tests and two-sample median tests.Results:For 1999–2011, after adjusting for age and ethnicity, breast cancer mortality in ever-screened women is estimated to be 62% (95% CI: 51–70) lower than in never-screened women. After further adjustment for screening selection bias, the mortality reduction in NZ is estimated to be 29% (95% CI: 20–38) at an average screening coverage of 64% for 2001–2011, and 34% (95% CI: 25–43) for recent screening coverage (2012–13, 71%). For irregularly screened women, the mortality reduction is estimated to be 31% (95% CI: 21–40), and 39% (95% CI: 22–52) in regularly screened women compared with never-screened women, after adjusting for age, ethnicity and screening selection bias (using recent 2012–2013 screening coverage of 71%). Ever-screened women diagnosed with breast cancer have more favourable prognostic indicators than never-screened women, with a higher proportion of localised cancer (63 compared with 46%), a higher proportion with a well-differentiated tumour (30 compared with 18%), lower risk of multiple tumours (RR=0.48) and smaller median tumour size (15 mm compared with 20 mm)—a...

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“…A study of delays to breast cancer surgical treatment in the Waikato region found the main driver for inequity in timeliness to surgery was greater access to private treatment among non-M aori women (Seneviratne et al 2015). In this study, among M aori women in the screening age group who were treated in the public sector, those who were diagnosed through BSA had shorter mean wait times to treatment than those who were not diagnosed through screening.…”

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confidence: 54%