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Primary and secondary care management of women with early breast cancer from affluent and deprived areas: retrospective review of hospital and general practice records

MacLeod, U., Ross, S., Twelves, C., George, W.D., Gillis, C., and Watt, G.C.M. (2000) Primary and secondary care management of women with early breast cancer from affluent and deprived areas: retrospective review of hospital and general practice records. British Medical Journal, 320 . pp. 1442-1445. ISSN 0959-535X (doi:10.1136/bmj.320.7247.1442)

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Publisher's URL: http://dx.doi.org/10.1136/bmj.320.7247.1442

Abstract

OBJECTIVES: To investigate whether poorer survival of breast cancer among deprived women compared with affluent women is related to their NHS care. DESIGN: Retrospective review of hospital and general practice case records. SETTING: Greater Glasgow Health Board area. SUBJECTS: Women diagnosed with breast cancer in 1992-3 who lived in the most affluent (deprivation categories 1 and 2) and the most deprived areas (deprivation categories 6 and 7) of Glasgow (Carstairs and Morris deprivation index). MAIN OUTCOME MEASURES: Breast cancer treatment, time from general practice consultation to clinic visit and surgery, and details of hospital admissions and follow up in primary and secondary care. RESULTS: The access to care and surgical and oncological treatment of women from affluent and deprived areas were similar. Admissions to hospital for problems not related to breast cancer were more common in those living in deprived areas (number admitted once or more: 51 (24%) v 13 (10%), P=0.001). Consultation patterns in general practice by the second year after diagnosis showed women in deprived areas consulting more frequently than women in affluent areas (median (interquartile range) number of consultations (5 (2-10) v 7 (4-13), P=0.01). CONCLUSION: Women living in affluent areas did not receive better NHS care for breast cancer than women in deprived areas. However, women from deprived areas seem to have greater comorbidity, and poorer outcomes from breast cancer among these women is probably due to factors which result in deprived communities having poorer health outcomes rather than to management of their breast cancer.

Item Type:Article
Status:Published
Refereed:Yes
Glasgow Author(s):Gillis, Prof Charles and MacLeod, Dr Una and Ross, Miss Susan
Authors: MacLeod, U., Ross, S., Twelves, C., George, W.D., Gillis, C., and Watt, G.C.M.
Subjects:R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
College/School:College of Medical Veterinary and Life Sciences
Journal Name:British Medical Journal
Journal Abbr.:BMJ
Publisher:BMJ Publishing Group
ISSN:0959-535X
ISSN (Online):1756-1833
Copyright Holders:© BMJ Publishing Group
First Published:First published in the BMJ 320:1442 - 1445
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher.

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