Document Type

Article

Publication Date

2010

Publication Title

The Breast Journal

Volume

16

Issue

4

First Page

416

Last Page

419

DOI

10.1111/j.1524-4741.2010.00922.x

Keywords

Adult, Aged, Breast Neoplasms/mortality, Breast Neoplasms/therapy, California/epidemiology, Canada/epidemiology, Female, Humans, Middle Aged, Social Class

Abstract

Effects of socioeconomic status on the long-term survival of 808 women with node-negative breast cancer in Canada and the United States were observed. Ontario and California samples diagnosed between 1988 and 1990 were followed until 2006. Socioeconomic data were taken from population censuses. Compared with their California counterparts, residents of low-income urban areas in Ontario experienced a significant 15-year survival advantage (RR = 1.66 [95% CI: 1.00, 2.76]). In these and other vulnerable, lower-middle- to working-class neighborhoods, significantly more Ontario residents gained access to adjuvant radiation therapy (RR = 1.75 [1.21, 2.53]) which seemed associated with better long-term survival (RR = 1.36 [0.99, 1.86]). This stage-adjusted, historical cohort analysis suggests much greater cancer care equity in Canada than in the United States.