The association of socioeconomic status on treatment strategy in patients with stage I and II breast cancer in the Netherlands

M. D. Filipe*, Sabine Siesling, M. R. Vriens, P. van Diest, A. J. Witkamp

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background
Previous studies have shown that socioeconomic status (SES) influences breast cancer therapy. However, these studies were performed in countries with unequal access to healthcare. Therefore, the aim of this study is to investigate whether SES also contributes to the likelihood of receiving a certain therapy in the Netherlands, a country with supposedly equal access to healthcare.
Materials and methods
From the Netherlands Cancer Registry, 105,287 patients with newly diagnosed stage I or II breast cancer diagnosed between 2011 and 2018 were selected for analysis. SES was calculated from the average incomes of each postal code, which were divided into 10 deciles. Primary outcome was the effect of SES on the likelihood of undergoing surgery and secondary outcome was the effect of SES on the likelihood of the type of surgery. Both outcomes were corrected for patient, tumor, and hospital characteristics and were expressed as odds ratio (OR) with 95% confidence interval (CI).
Results
SES did not affect the likelihood of a breast cancer patient to undergo surgery (OR 1.00 per 10% stratum). In contrast, increased age and higher tumor stage were the most important factors determining whether patients underwent surgery. Patients with higher SES were less likely to undergo mastectomy (OR 0.98). Additionally, more recently diagnosed patients were less likely to undergo mastectomy (OR 0.93 per year) while patients with higher tumor stage were more likely to undergo mastectomy (OR 3.42).
Conclusion
SES does not affect whether a patient undergoes surgery; however, higher SES increased the likelihood of BCT.
Original languageEnglish
Number of pages10
JournalBreast cancer research and treatment
Early online date26 Jun 2021
DOIs
Publication statusE-pub ahead of print/First online - 26 Jun 2021

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