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  • Title: Inequalities in breast cancer stage at diagnosis in the Trent region, and implications for the NHS Breast Screening Programme.
    Author: Cuthbertson SA, Goyder EC, Poole J.
    Journal: J Public Health (Oxf); 2009 Sep; 31(3):398-405. PubMed ID: 19423544.
    Abstract:
    BACKGROUND: This study investigates risk factors for diagnosis with late-stage breast cancer in order to identify inequalities and inform the understanding of barriers affecting access to mammography screening. METHODS: Data from the Trent Cancer Registry were used to identify all women with invasive breast cancer, diagnosed in 1998-2006. Risk of diagnosis with late-stage breast cancer was calculated to quantify strength of association between exposure and outcome. RESULTS: Women outside the age group for routine screening were approximately 30% [<50 years, relative risk (RR) = 1.34 (95% confidence interval, CI: 1.26-1.43) and >70 years, RR = 1.27 (95% CI: 1.19-1.36)] more likely to be diagnosed with late-stage breast cancer; the most deprived women were 37% [RR = 1.37 (95% CI: 1.01-2.56)] more likely to be diagnosed with Stage IV breast cancer; ethnic minority women were 15% [RR = 1.15 (95% CI: 1.09-1.22)] more likely to be diagnosed with late-stage breast cancer and women resident in 5 of 11 Trent Primary Care Trusts (PCT) had a greater than 30% increased risk of diagnosis with late-stage breast cancer than those in Nottingham City PCT. CONCLUSION: These findings highlight the need for appropriate targeted interventions to address compositional and contextual inequalities that are evident in breast cancer stage at diagnosis.
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