1. Predictive factors of the survival of women with invasive breast cancer in French Guiana: the burden of health inequalities
- Author
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Sophie Belliardo, Maylis Douine, Tristan Roue, Sylvain Labbé, Mathieu Nacher, Juliette Plenet, Registre des Cancers de Guyane, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), The present study was funded by the Health Regional Agency of French Guiana., The authors thank Professor J.P. Droz for a critical reading of the manuscript., Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and ADENIS, ANTOINE
- Subjects
Cancer Research ,Pediatrics ,Survival ,Immigration ,Health Services Accessibility ,MESH: Healthcare Disparities/statistics & numerical data ,0302 clinical medicine ,Breast cancer ,MESH: Aged, 80 and over ,Risk Factors ,MESH: Risk Factors ,Medicine ,030212 general & internal medicine ,Early Detection of Cancer ,MESH: Breast Neoplasms/pathology ,media_common ,Aged, 80 and over ,MESH: Aged ,MESH: Middle Aged ,Relative survival ,Carcinoma, Ductal, Breast ,Age Factors ,MESH: Neoplasm Staging ,Place of birth ,Middle Aged ,Prognosis ,MESH: Emigrants and Immigrants ,3. Good health ,French Guiana ,Survival Rate ,Oncology ,MESH: Breast Neoplasms/mortality ,030220 oncology & carcinogenesis ,MESH: Survival Analysis ,Female ,Immigrant ,Adult ,medicine.medical_specialty ,MESH: Socioeconomic Factors ,MESH: Early Detection of Cancer/statistics & numerical data ,MESH: French Guiana/epidemiology ,MESH: Survival Rate ,media_common.quotation_subject ,Emigrants and Immigrants ,Breast Neoplasms ,MESH: Carcinoma, Ductal, Breast/mortality ,MESH: Prognosis ,03 medical and health sciences ,South America Word count : 2278 ,MESH: Health Services Accessibility ,parasitic diseases ,Humans ,Healthcare Disparities ,Survival rate ,Survival analysis ,Aged ,Neoplasm Staging ,MESH: Age Factors ,MESH: Humans ,business.industry ,MESH: Adult ,medicine.disease ,Survival Analysis ,MESH: Carcinoma, Ductal, Breast/pathology ,Cancer registry ,Metropolitan France ,Socioeconomic Factors ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,MESH: Female ,Demography - Abstract
International audience; This study aimed to compare the relative survival of patients with invasive breast cancer between women from French Guiana (a French territory in South America) and metropolitan France. No study hadever compared survival of breast cancer on the basis of immigrant status in France. Our study underlined that access to care for migrants is challenging whichwgenerates health inequalities. Background The prognosis of breast cancer in French Guiana is worse than in France with 23 deaths per 100 incident cases against 17 per 100 in metropolitan France. This study aimed to compare relative survival of patients with invasive breast cancer (IBC) between women from French Guiana and metropolitan France and to determine risk factors influencing breast cancer survival in French Guiana.Materials and methods Data were collected from the Cancer registry of French Guiana. We comparedthe relative survival of women with IBC between French Guiana and metropolitan France. We used Cox's proportional hazard regression to evaluate the effect of prognostic factors on cancer-specific mortality in French Guiana. Results We included all 269 cases of IBC in women diagnosed in French Guiana between 2003 and 2009. The overall 5-year relative survival rate of patients with IBC was 79% in French Guiana and 86% in metropolitan France. The place of birth (foreign country versus French territory), the tumor stage at the time of diagnosis, the mode of diagnosis (symptoms versus screening), the presence of hormone receptors in the tumor and the histologic type were the variables associated with survival differences. None of the other study variables were significantly associated with prognosis. Conclusion Access to care for migrants is challenging,which leads to health inequalities. Early detection through prevention programs is crucial to increaseIBC survival notably for foreign-born patients.
- Published
- 2016