Treatment variation in patients diagnosed with early stage breast cancer in Alberta from 2002 to 2010: a population-based study

BMC Health Services Research

Marcy Winget³  Kelly Dabbs¹  Yutaka Yasui²  He Gao²  Stacey Fisher² 

[1] Department of Surgery, University of Alberta, Edmonton, Alberta, Canada;School of Public Health, University of Alberta, Edmonton, Alberta, Canada;Department of Medicine, Stanford University, Palo Alto, CA, USA

关键词: Surgery;    Radiotherapy;    Population-based;    Breast cancer;   

Others  :  1089780
DOI  :  10.1186/s12913-015-0680-z

 received in 2014-07-15, accepted in 2015-01-05,  发布年份 2015

【 摘 要 】

Background

Breast-conserving surgery (BCS) followed by radiotherapy is generally the preferred treatment for women diagnosed with early stage breast cancer. This study aimed to investigate the proportion of patients who receive BCS versus mastectomy and post-BCS radiotherapy, and explore factors associated with receipt of these treatments in Alberta, Canada.

Methods

A retrospective population-based study was conducted that including all patients surgically treated with stage I-III breast cancer diagnosed in Alberta from 2002–2010. Clinical characteristics, treatment information and patient age at diagnosis were collected from the Alberta Cancer Registry. Log binomial multiple regression was used to calculate stage-specific relative risk estimates of receiving BCS and post-BCS radiotherapy.

Results

Of the 14 646 patients included in the study, 44% received BCS, and of those, 88% received post-BCS radiotherapy. The adjusted relative risk of BCS was highest in Calgary and lowest in Central Alberta for all disease stages. Relative to surgeries performed in Calgary, those performed in Central Alberta were significantly less likely to be BCS for stage I (RR = 0.65; 95% 0.57, 0.72), II (RR = 0.58; 95% 0.49, 0.68), and III (RR = 0.62; 95% CI: 0.37, 0.95) disease, respectively, adjusting for patient age at diagnosis, clinical and treatment characteristics. No significant variation of post-BCS radiotherapy was found.

Conclusions

Factors such as region of surgical treatment should not be related to the receipt of standard care within a publicly-funded health care system. Further investigation is needed to understand the significant geographic variation present within the province in order to identify appropriate interventions.

【 授权许可】

   
2015 Fisher et al.; licensee BioMed Central.

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