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Author(s): Katie Marvin-Dowle [sup.1] , Hora Soltani [sup.1] Author Affiliations: (1) grid.5884.1, 0000 0001 0303 540X, Faculty of Health and Wellbeing, College of Health, Wellbeing and Life Sciences, Sheffield Hallam [...], Objectives There exists a body of research regarding ethnic differences in perinatal health whereas this is not the case concerning the role of migration status and acculturation in attenuating these differences. This study aims to investigate determinants of health during pregnancy up to one-year postpartum by migration status. Methods The study utilises data collected by the Born in Bradford cohort. The focus of analysis was migration status groupings, based on self-reported country of birth of participants and their parents and grandparents. Chi-Square, one-way ANOVA and correlation coefficients examined relationships between variables. Results Migrant women were less likely to smoke (native: 34.4%, 1st generation: 2.8%, 2nd generation: 8.6%) or to be obese (native: 25.5%, 1st generation: 17.4%, 2nd generation: 21.3%) compared to native women. Migrants were less physically active at 6 months (Mean (SD) minutes/week: native 265 (245), 1st generation 113 (162), 2nd generation 147 (182)) with larger increases in BMI over time compared to native women. Migrant women were more likely to be suffering psychological distress at baseline and 6 months postpartum and migrant families were more likely to live in areas of high socio-economic deprivation, despite higher levels of educational attainment. Conclusions for Practice This study ethnicity and migration identifies some important differences between ethnic groups with different migration histories, therefore indicating that healthcare professionals should consider eliciting full migration histories to improve care. The impact of these differences on perinatal outcomes is a priority for future research.

Historically, rural populations appear to have unique challenges accessing cancer services, though the impact on patient outcomes is not well understood. In British Columbia (BC) (1) and in Canada as [...], Objective: Residents of rural communities have decreased access to cancer screening and treatments compared to urban residents, though use of resources and patient outcomes have not been assessed with a comprehensive population-based analysis. The objectives of this study were to investigate whether breast cancer screening and treatments were utilized less frequently in rural BC and whether this translated into differences in outcomes. Methods: All patients diagnosed with breast cancer in British Columbia (BC) during 2002 were identified from the Cancer Registry and linked to the Screening Mammography database. Patient demographics, pathology, stage, treatments, mammography use and death data were abstracted. Patients were categorized as residing in large, small and rural local health authorities (LHAs) using Canadian census information. Use of resources and outcomes were compared across these LHA size categories. We hypothesized that mastectomy rates (instead of breast-conserving surgery) would be higher in rural areas, since breast conservation is standardly accompanied by adjuvant radiotherapy, which has limited availability in rural BC. In contrast we hypothesized that cancer screening and systemic therapy use would be similar, as they are more widely dispersed across BC. Exploratory analyses were performed to assess whether disparities in screening and treatment utilization translated into differences in survival. Results: 2,869 breast cancer patients were included in our study. Patients from rural communities presented with more advanced disease (p=0.01). On multivariable analysis, patients from rural, compared to urban, LHAs were less likely to be screening mammography attendees (OR=0.62; p Conclusion: There was a significant difference in screening mammography use, stage distribution and loco-regional treatments use by population size of LHA. After controlling for differences in patient and tumour factors by LHA, survival was not significantly different. Key words: Breast cancer; mammography; breast conserving surgery; mastectomy; rural; hormonal therapy; chemotherapy Objectifs : Comparativement aux residents des zones urbaines, les residents des communautes rurales ont moins acces au depistage et aux traitements du cancer, mais l'on n'a pas encore evalue l'utilisation des ressources par les patients, ni les resultats sanitaires de ces patients, a l'aide d'analyses populationnelles globales. Notre etude visait a determiner si le depistage et les traitements du cancer du sein etaient utilises moins souvent dans les regions rurales de la Colombie-Britannique (C.-B.), et si cela se traduisait par des resultats differents. Methode : Nous avons repertorie toutes les personnes ayant recu un diagnostic de cancer du sein en C.-B. en 2002 en consultant le Registre du cancer, et nous avons lie ces donnees a celles de la base de donnees des mammographies de depistage. Nous en avons extrait les donnees demographiques, la pathologie, le stade, les traitements, le recours a la mammographie et les donnees de mortalite des patientes. A l'aide des donnees du Recensement du Canada, nous avons classe les patientes selon leur lieu de residence (leur autorite sanitaire locale [ASL] : petite, grande ou rurale), puis compare l'utilisation des ressources et les resultats sanitaires pour chaque categorie d'ASL. Nous avons suppose que les taux de mastectomie (par opposition a la chirurgie mammaire conservatrice) seraient superieurs dans les regions rurales, la conservation du sein etant normalement accompagnee par la radiotherapie adjuvante, laquelle est peu disponible dans les zones rurales de la province. Par contre, nous avons suppose que les taux d'utilisation du depistage du cancer et des traitements systemiques seraient semblables, car ces services sont disponibles dans toute la province. Nous avons effectue des analyses exploratoires pour determiner si les disparites dans l'utilisation du depistage et des traitements se traduisaient par des ecarts dans la survie. Resultats : Notre etude a porte sur 2 869 femmes atteintes de cancer du sein. Les patientes des communautes rurales se sont presentees avec des cancers a un stade plus avance (p=0,01). Apres analyse multivariee, les patientes provenant des ASL rurales, et non urbaines, etaient moins susceptibles d'avoir subi une mammographie de depistage (RC=0,62; p Conclusion : On observe des ecarts significatifs dans le recours aux mammographies de depistage, la distribution selon le stade de cancer et l'utilisation locale-regionale des traitements en fonction de la taille de la population de l'ASL. Compte tenu des ecarts par ASL dans les facteurs lies aux patientes et aux tumeurs, la survie n'etait pas significativement differente. Mots cles : cancer du sein; mammographie; chirurgie mammaire conservatrice; mastectomie; rural; hormonotherapie; chimiotherapie

Three per cent of women aged 40-74 in Britain have never had either breast or cervical cancer screening. Researchers in Oxford and Sheffield investigated the relationship between women's reported use [...]