From the Department of Surgery, McMaster University, Hamilton, Ont. (Li, Cornacchi, Farrokhyar, Forbes, Reid, Hodgson, Lucibello, Lovrics); the Department of Surgical Oncology, Hamilton Health Sciences and Juravinski Hospital and Cancer Centre, Hamilton, Ont. (Forbes, Rid, Hodgson, Lovrics); the Department of Surgery, St. Joseph’s Healthcare, Hamilton, Ont. (Lovrics); and the Department of Medicine, McMaster University, Hamilton, Ont. (Johnston).
Can J Surg. 2019 Apr 1;62(2):83-92. doi: 10.1503/cjs.009217.
Studies have shown an association between socioeconomic status and breast cancer treatment. We examined the relation between socioeconomic status and the treatment of breast cancer (surgical, systemic and radiation) in a universal health care system.
Data from a single urban Canadian centre were collected for consecutive patients who received a diagnosis of breast cancer from January 2010 to December 2011. Variables included patient and disease factors, surgery type, systemic and radiation treatment, and breast reconstruction. Socioeconomic variables were obtained from 2006 Canadian census data. We used multivariable logistic regression to identify predictors of breast cancer treatment.
A total of 721 patients were treated for breast cancer during the study period. Socioeconomic variables were not related to type of breast surgery for breast cancer. Age less than 50 years, having a first-degree relative with breast cancer and income status were predictors of breast reconstruction. Employment status was a consistent predictor of systemic and radiation treatment.
Employment consistently predicted systemic and radiation treatment, and age and income were predictors of breast reconstruction in a universal health care system. Further research is required to determine precisely how socioeconomic factors affect care and to minimize possible disparities in delivery of health care services.
研究表明社会经济地位与乳腺癌治疗之间存在关联。我们在全民医疗保健体系中研究了社会经济地位与乳腺癌（手术、全身和放疗）治疗之间的关系。
从 2010 年 1 月至 2011 年 12 月，对在加拿大一个城市中心连续接受乳腺癌诊断的患者收集数据。变量包括患者和疾病因素、手术类型、全身和放疗以及乳房重建。社会经济变量来自 2006 年加拿大人口普查数据。我们使用多变量逻辑回归来确定乳腺癌治疗的预测因素。
在研究期间，共有 721 名患者接受了乳腺癌治疗。社会经济变量与乳腺癌手术类型无关。年龄小于 50 岁、有一级亲属患有乳腺癌和收入状况是乳房重建的预测因素。就业状况是全身治疗和放疗的一致预测因素。
在全民医疗保健体系中，就业状况一致预测全身治疗和放疗，而年龄和收入是乳房重建的预测因素。需要进一步研究以确定社会经济因素如何影响护理，并尽量减少医疗服务提供方面可能存在的差异。
