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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Stage at breast cancer diagnosis and distance from diagnostic hospital in a peri-urban setting: A South African public hospital case series of over 1000 women</title><author><name sortKey="Dickens, Caroline" sort="Dickens, Caroline" uniqKey="Dickens C" first="Caroline" last="Dickens">Caroline Dickens</name><affiliation><nlm:aff id="A1">Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Johannesburg 2193, South Africa</nlm:aff></affiliation></author><author><name sortKey="Joffe, Maureen" sort="Joffe, Maureen" uniqKey="Joffe M" first="Maureen" last="Joffe">Maureen Joffe</name><affiliation><nlm:aff id="A3">Wits Health Consortium, MRC/Wits Developmental Pathways to Health Research Unit, Faculty of Health Sciences, University of Witwatersrand</nlm:aff></affiliation></author><author><name sortKey="Jacobson, Judith" sort="Jacobson, Judith" uniqKey="Jacobson J" first="Judith" last="Jacobson">Judith Jacobson</name><affiliation><nlm:aff id="A4">Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA</nlm:aff></affiliation></author><author><name sortKey="Venter, Francois" sort="Venter, Francois" uniqKey="Venter F" first="Francois" last="Venter">Francois Venter</name><affiliation><nlm:aff id="A5">Information Management Directorate, Gauteng Provincial Department of Health, 37 Sauer Street, Bank of Lisbon, Marshall Town, Johannesburg, 2000, South Africa</nlm:aff></affiliation></author><author><name sortKey="Schuz, Joachim" sort="Schuz, Joachim" uniqKey="Schuz J" first="Joachim" last="Schüz">Joachim Schüz</name><affiliation><nlm:aff id="A1">Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France</nlm:aff></affiliation></author><author><name sortKey="Cubasch, Herbert" sort="Cubasch, Herbert" uniqKey="Cubasch H" first="Herbert" last="Cubasch">Herbert Cubasch</name><affiliation><nlm:aff id="A6">Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Johannesburg 2193, South Africa</nlm:aff></affiliation><affiliation><nlm:aff id="A7">Chris Hani Baragwanath Hospital Breast Clinic, Old Potch Road, Soweto, South Africa</nlm:aff></affiliation></author><author><name sortKey="Mccormack, Valerie" sort="Mccormack, Valerie" uniqKey="Mccormack V" first="Valerie" last="Mccormack">Valerie Mccormack</name><affiliation><nlm:aff id="A1">Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24658866</idno><idno type="pmc">4134722</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4134722</idno><idno type="RBID">PMC:4134722</idno><idno type="doi">10.1002/ijc.28861</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">001788</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001788</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Stage at breast cancer diagnosis and distance from diagnostic hospital in a peri-urban setting: A South African public hospital case series of over 1000 women</title><author><name sortKey="Dickens, Caroline" sort="Dickens, Caroline" uniqKey="Dickens C" first="Caroline" last="Dickens">Caroline Dickens</name><affiliation><nlm:aff id="A1">Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Johannesburg 2193, South Africa</nlm:aff></affiliation></author><author><name sortKey="Joffe, Maureen" sort="Joffe, Maureen" uniqKey="Joffe M" first="Maureen" last="Joffe">Maureen Joffe</name><affiliation><nlm:aff id="A3">Wits Health Consortium, MRC/Wits Developmental Pathways to Health Research Unit, Faculty of Health Sciences, University of Witwatersrand</nlm:aff></affiliation></author><author><name sortKey="Jacobson, Judith" sort="Jacobson, Judith" uniqKey="Jacobson J" first="Judith" last="Jacobson">Judith Jacobson</name><affiliation><nlm:aff id="A4">Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA</nlm:aff></affiliation></author><author><name sortKey="Venter, Francois" sort="Venter, Francois" uniqKey="Venter F" first="Francois" last="Venter">Francois Venter</name><affiliation><nlm:aff id="A5">Information Management Directorate, Gauteng Provincial Department of Health, 37 Sauer Street, Bank of Lisbon, Marshall Town, Johannesburg, 2000, South Africa</nlm:aff></affiliation></author><author><name sortKey="Schuz, Joachim" sort="Schuz, Joachim" uniqKey="Schuz J" first="Joachim" last="Schüz">Joachim Schüz</name><affiliation><nlm:aff id="A1">Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France</nlm:aff></affiliation></author><author><name sortKey="Cubasch, Herbert" sort="Cubasch, Herbert" uniqKey="Cubasch H" first="Herbert" last="Cubasch">Herbert Cubasch</name><affiliation><nlm:aff id="A6">Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Johannesburg 2193, South Africa</nlm:aff></affiliation><affiliation><nlm:aff id="A7">Chris Hani Baragwanath Hospital Breast Clinic, Old Potch Road, Soweto, South Africa</nlm:aff></affiliation></author><author><name sortKey="Mccormack, Valerie" sort="Mccormack, Valerie" uniqKey="Mccormack V" first="Valerie" last="Mccormack">Valerie Mccormack</name><affiliation><nlm:aff id="A1">Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France</nlm:aff></affiliation></author></analytic><series><title level="j">International journal of cancer. Journal international du cancer</title><idno type="ISSN">0020-7136</idno><idno type="eISSN">1097-0215</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="P1">Advanced stage at diagnosis contributes to low breast cancer survival rates in sub-Saharan Africa. Living far from health services is known to delay presentation, but the effect of distance, the radius at which the effect sets in and the women most affected has not been quantified. In a peri-urban South African setting, we examined the effect of a GIS-measured straight-line distance, from a patient’s residence to diagnostic hospital, on stage at diagnosis in 1071 public-sector breast cancer patients diagnosed during 2006–12. Generalized linear models were used to estimate risk ratios for late stage (stage III/IV vs stage I/II) associated with distance, adjusting for year of diagnosis, age, race and socioeconomic indicators. Mean age of patients was 55 years, 90% were Black African, and diagnoses were at stages I (5%), II (41%), III (46%) and IV (8%). 62% of patients with distances >20 km (n=347) had a late stage at diagnosis compared to 50% with distances <20 km (n=724, p=0.02). Risk of late stage at diagnosis was 1.25-fold higher (95% CI: 1.09, 1.42) per 30 km. Effects were pronounced in an under-represented group of patients over age 70. This positive stage-distance association held to 40 km, and plateaued or slightly reversed in patients (9%) living beyond this distance. Studies of woman and the societal and healthcare-level influences on these delays and on the late stage at diagnosis distribution are needed to inform interventions that improve diagnostic stage and breast cancer survival rates in this and similar settings.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0042124</journal-id><journal-id journal-id-type="pubmed-jr-id">4284</journal-id><journal-id journal-id-type="nlm-ta">Int J Cancer</journal-id><journal-id journal-id-type="iso-abbrev">Int. J. Cancer</journal-id><journal-title-group><journal-title>International journal of cancer. Journal international du cancer</journal-title></journal-title-group><issn pub-type="ppub">0020-7136</issn><issn pub-type="epub">1097-0215</issn></journal-meta><article-meta><article-id pub-id-type="pmid">24658866</article-id><article-id pub-id-type="pmc">4134722</article-id><article-id pub-id-type="doi">10.1002/ijc.28861</article-id><article-id pub-id-type="manuscript">NIHMS579211</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Stage at breast cancer diagnosis and distance from diagnostic hospital in a peri-urban setting: A South African public hospital case series of over 1000 women</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Dickens</surname><given-names>Caroline</given-names></name><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Joffe</surname><given-names>Maureen</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Jacobson</surname><given-names>Judith</given-names></name><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Venter</surname><given-names>Francois</given-names></name><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Schüz</surname><given-names>Joachim</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Cubasch</surname><given-names>Herbert</given-names></name><xref ref-type="aff" rid="A6">6</xref><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><name><surname>McCormack</surname><given-names>Valerie</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib></contrib-group><aff id="A1"><label>1</label>Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France</aff><aff id="A2"><label>2</label>Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Johannesburg 2193, South Africa</aff><aff id="A3"><label>3</label>Wits Health Consortium, MRC/Wits Developmental Pathways to Health Research Unit, Faculty of Health Sciences, University of Witwatersrand</aff><aff id="A4"><label>4</label>Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA</aff><aff id="A5"><label>5</label>Information Management Directorate, Gauteng Provincial Department of Health, 37 Sauer Street, Bank of Lisbon, Marshall Town, Johannesburg, 2000, South Africa</aff><aff id="A6"><label>6</label>Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Johannesburg 2193, South Africa</aff><aff id="A7"><label>7</label>Chris Hani Baragwanath Hospital Breast Clinic, Old Potch Road, Soweto, South Africa</aff><author-notes><corresp id="FN1">Corresponding Author: Valerie McCormack, Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, FRANCE, <email>mccormackv@iarc.fr</email>, Tel: +33 (0) 4 72 73 85 66; Fax: +33 (0) 4 72 73 83 20</corresp></author-notes><pub-date pub-type="nihms-submitted"><day>15</day><month>5</month><year>2014</year></pub-date><pub-date pub-type="epub"><day>07</day><month>4</month><year>2014</year></pub-date><pub-date pub-type="ppub"><day>1</day><month>11</month><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>11</month><year>2015</year></pub-date><volume>135</volume><issue>9</issue><fpage>2173</fpage><lpage>2182</lpage><pmc-comment>elocation-id from pubmed: 10.1002/ijc.28861</pmc-comment>
<abstract><p id="P1">Advanced stage at diagnosis contributes to low breast cancer survival rates in sub-Saharan Africa. Living far from health services is known to delay presentation, but the effect of distance, the radius at which the effect sets in and the women most affected has not been quantified. In a peri-urban South African setting, we examined the effect of a GIS-measured straight-line distance, from a patient’s residence to diagnostic hospital, on stage at diagnosis in 1071 public-sector breast cancer patients diagnosed during 2006–12. Generalized linear models were used to estimate risk ratios for late stage (stage III/IV vs stage I/II) associated with distance, adjusting for year of diagnosis, age, race and socioeconomic indicators. Mean age of patients was 55 years, 90% were Black African, and diagnoses were at stages I (5%), II (41%), III (46%) and IV (8%). 62% of patients with distances >20 km (n=347) had a late stage at diagnosis compared to 50% with distances <20 km (n=724, p=0.02). Risk of late stage at diagnosis was 1.25-fold higher (95% CI: 1.09, 1.42) per 30 km. Effects were pronounced in an under-represented group of patients over age 70. This positive stage-distance association held to 40 km, and plateaued or slightly reversed in patients (9%) living beyond this distance. Studies of woman and the societal and healthcare-level influences on these delays and on the late stage at diagnosis distribution are needed to inform interventions that improve diagnostic stage and breast cancer survival rates in this and similar settings.</p></abstract><kwd-group><kwd>breast neoplasms</kwd><kwd>early diagnosis</kwd><kwd>South Africa</kwd><kwd>disparities</kwd><kwd>stage at diagnosis</kwd><kwd>geographical</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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