Please use this identifier to cite or link to this item:
|Title:||Outcomes of Breast Cancer in Brazil Related to Health Care Coverage: A Retrospective Cohort Study|
|Authors:||Liedke, Pedro E. R.|
Finkelstein, Dianne M.
Barrios, Carlos H.
Simon, Sergio D. [UNIFESP]
Goss, Paul E.
Brazilian Breast Canc Study Grp GBECAM
Universidade Federal de São Paulo (UNIFESP)
Hosp Clin Porto Alegre
PUCRS Sch Med Porto Alegre
Natl Canc Inst Brazil INCA
Massachusetts Gen Hosp
|Publisher:||Amer Assoc Cancer Research|
|Citation:||Cancer Epidemiology Biomarkers & Prevention. Philadelphia: Amer Assoc Cancer Research, v. 23, n. 1, p. 126-133, 2014.|
|Abstract:||Background: Breast cancer is the most common malignancy in women in Brazil. Differences between patients with public versus private healthcare coverage about general characteristics, disease presentation, treatment of primary tumors, and clinical outcomes have not been fully investigated.Methods: A national, retrospective cohort of 3,142 patients drawn from a representative sample of Brazilian medical centers was selected. Clinical and demographic data and type of healthcare coverage were retrieved by chart review. Groups were compared using the x(2) test. the log-rank test was used for comparison of disease-free survival (DFS), postrelapse, and overall survival (OS). Multivariate Cox regression modeling with adjustment for patient characteristics and stage at diagnosis was performed. All P values are two sided.Results: Patients with public health coverage presented with more advanced disease at diagnosis (P < 0.001). DFS and OS for patients presenting with stage 0-II disease did not differ according to the type of healthcare coverage, whereas a significant difference in outcomes was seen for stage III-IV patients (P = 0.002 and P = 0.008, respectively). in a Cox multivariate analysis, no association was found for the type of health coverage with either DFS or OS, but there was an association for postrelapse survival (P < 0.001).Conclusion: in Brazil, patients with breast cancer with public health coverage present with more advanced disease, and this possibly explains worse DFS and OS when compared with those with private coverage.Impact: Earlier diagnosis and treatment of breast cancer could improve outcomes of women with public health coverage in Brazil. (C)2013 AACR.|
|Appears in Collections:||Em verificação - Geral|
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.