Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Association Between Socioeconomic Status and All-Cause Mortality After Breast Cancer Surgery: Nationwide Retrospective Cohort Study

사회경제적 위치와 유방암 수술 후 총 사망위험과의 관련성

  • Park, Mi-Jin (Graduate School of Public Health, Yonsei University) ;
  • Chung, Woo-Jin (Graduate School of Public Health, Yonsei University) ;
  • Lee, Sun-Mi (Health Insurance Policy Research Institute, National Health Insurance Corporation) ;
  • Park, Jong-Hyock (National Cancer Control Research Institute, National Cancer Center) ;
  • Chang, Hoo-Sun (Graduate School of Public Health, Yonsei University)
  • 박미진 (연세대학교 보건대학원) ;
  • 정우진 (연세대학교 보건대학원) ;
  • 이선미 (국민건강보험공단 건강보험정책연구원) ;
  • 박종혁 (국립암센터 국가암관리사업단) ;
  • 장후선 (연세대학교 보건대학원)
  • Received : 2009.12.28
  • Accepted : 2010.04.02
  • Published : 2010.07.31
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Abstract

Objectives: This study aims to evaluate and explain the socioeconomic inequalities of all-cause mortality after breast cancer surgery in South Korea. Methods: This population based study included all 8868 females who underwent radical mastectomy for breast cancer between January 2002 and June 2003. Follow-up for mortality continued from January 2002 to June 2006. The patients were divided into 4 socioeconomic classes according to their socioeconomic status as defined by the National Health Insurance contribution rate. The relationship between socioeconomic status and all-cause mortality after breast cancer surgery was assessed using the Cox proportional hazards model with adjusting for age, the Charlson’s index score, emergency hospitalization, the type of hospital and the hospital ownership. Results: Those in the lowest socioeconomic status group had a significantly higher hazard ratio of 2.09 (95% CI =1.50 - 2.91) compared with those in the highest socioeconomic group after controlling for all the identifiable confounding variables. For allcause mortality after radical mastectomy, all the other income groups showed significantly higher 3-year mortality rates than did the highest income group. Conclusions: The socioeconomic status of breast cancer patients should be considered as an independent prognostic factor that affects all-cause mortality after radical mastectomy, and this is possibly due to a delayed diagnosis, limited access or minimal treatment leading to higher mortality. This study may provide tangible support to intensify surveillance and treatment for breast cancer among low socioeconomic class women.

Keywords

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