Geographical differences in risk of advanced breast cancer: Limited evidence for reductions over time, Queensland, Australia 1997-2014

Journal article

Dasgupta, Paramita, Youl, Philippa H., Aitken, Joanne F., Turrell, Gavin and Baade, Peter. (2017). Geographical differences in risk of advanced breast cancer: Limited evidence for reductions over time, Queensland, Australia 1997-2014. The Breast. 36, pp. 60 - 66. https://doi.org/10.1016/j.breast.2017.09.005
AuthorsDasgupta, Paramita, Youl, Philippa H., Aitken, Joanne F., Turrell, Gavin and Baade, Peter
Abstract

Background
Reducing geographical inequalities in breast cancer stage remains a key focus of public health policy. We explored whether patterns of advanced breast cancer by residential accessibility and disadvantage in Queensland, Australia, have changed over time.
Methods
Population-based cancer registry study of 38,706 women aged at least 30 years diagnosed with a first primary invasive breast cancer of known stage between 1997 and 2014. Multilevel logistic regression was used to examine temporal changes in associations of area-level factors with odds of advanced disease after adjustment for individual-level factors.
Results
Overall 19,401 (50%) women had advanced breast cancer. Women from the most disadvantaged areas had higher adjusted odds (OR = 1.23 [95%CI 1.13, 1.32]) of advanced disease than those from least disadvantaged areas, with no evidence this association had changed over time (interaction p = 0.197). Living in less accessible areas independently increased the adjusted odds (OR = 1.18 [1.09, 1.28]) of advanced disease, with some evidence that the geographical inequality had reduced over time (p = 0.045). Sensitivity analyses for un-staged cases showed that the original associations remained, regardless of assumptions made about the true stage distribution.
Conclusions
Both geographical and residential socioeconomic inequalities in advanced stage diagnoses persist, potentially reflecting barriers in accessing diagnostic services. Given the role of screening mammography in early detection of breast cancer, the lack of population-based data on private screening limits our ability to determine overall participation rates by residential characteristics. Without such data, the efficacy of strategies to reduce inequalities in breast cancer stage will remain compromised.

KeywordsBreast cancer; Stage; Geography; Trends; Socioeconomic
Year2017
JournalThe Breast
Journal citation36, pp. 60 - 66
PublisherChurchill Livingstone
ISSN0960-9776
Digital Object Identifier (DOI)https://doi.org/10.1016/j.breast.2017.09.005
Scopus EID2-s2.0-85030679627
Page range60 - 66
Research GroupInstitute for Health and Ageing
Publisher's version
File Access Level
Controlled
Place of publicationUnited Kingdom
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Burton, Nicola W., Khan, Asaduzzaman, Brown, Wendy J. and Turrell, Gavin. (2011). The association between sedentary leisure and physical activity in middle-aged adults. British Journal of Sports Medicine. 46, pp. 747 - 752. https://doi.org/10.1136/bjsm.2010.081430
Test-retest reliability of perceptions of the neighborhood environment for physical activity by socioeconomic status
Turrell, Gavin, Haynes, Michele A., O'Flaherty, Martin, Burton, Nicola W., Giskes, Katrina, Giles-Corti, Billie and Wilson, Lee-Ann. (2011). Test-retest reliability of perceptions of the neighborhood environment for physical activity by socioeconomic status. Journal of Physical Activity and Health. 8(6), pp. 829 - 840. https://doi.org/10.1123/jpah.8.6.829
Perceived weight status may contribute to education inequalities in five-year weight change among mid-aged women
Siu, Jessica, Giskes, Katrina, Shaw, Jonathan and Turrell, Gavin. (2011). Perceived weight status may contribute to education inequalities in five-year weight change among mid-aged women. Australian and New Zealand Journal of Public Health. 35, pp. 284 - 291. https://doi.org/10.1111/j.1753-6405.2010.00705.x
Traditional birth attendant training and local birthing practices in India
Saravanan, Sheela, Turrell, Gavin, Johnson, Helen, Fraser, Jenny and Patterson, Carla. (2011). Traditional birth attendant training and local birthing practices in India. Evaluation and Program Planning. 34(3), pp. 254 - 265. https://doi.org/10.1016/j.evalprogplan.2011.02.012
Birthing practices of traditional birth attendants in South Asia in the context of training programmes
Saravanan, Sheela, Turrell, Gavin, Johnson, Helen and Fraser, Jennifer. (2010). Birthing practices of traditional birth attendants in South Asia in the context of training programmes. Journal of Health Management. 12(2), pp. 93 - 121. https://doi.org/10.1177/097206341001200201
A multilevel study of the determinants of area-level inequalities in colorectal cancer survival
Baade, Peter D., Turrell, Gavin and Aitken, Joanne F.. (2010). A multilevel study of the determinants of area-level inequalities in colorectal cancer survival. BMC Cancer. 10(1), p. Article 24. https://doi.org/10.1186/1471-2407-10-24
Associations among smoking status, lifestyle and lipoprotein subclasses
Beauchamp, Allison, Tonkin, Andrew, Peeters, A, Wolfe, R, Turrell, Gavin, Harriss, Linton, Giles, Graham G., English, Dallas and Jenkins, Alicia J.. (2010). Associations among smoking status, lifestyle and lipoprotein subclasses. Journal of Clinical Lipidology. 4(6), pp. 522 - 530. https://doi.org/10.1016/j.jacl.2010.09.003
Inequalities in cardiovascular disease mortality: the role of behavioural, physiological and social risk factors.
Beauchamp, Allison, Peeters, A., Wolfe, R., Turrell, Gavin, Harriss, Linton, Giles, Graham G., English, Dallas, McNeil, John, Magliano, Dianna J., Harrap, Stephen, Liew, Danny, Hunt, David and Tonkin, Andrew. (2010). Inequalities in cardiovascular disease mortality: the role of behavioural, physiological and social risk factors. Journal of Epidemiology and Community Health. 64(6), pp. 542 - 548. https://doi.org/10.1136/jech.2009.094516
Socioeconomic position, gender, health behaviours and biomarkers of cardiovascular disease and diabetes
Kavanagh, Anne M., Bentley, Rebecca J., Turrell, Gavin, Shaw, J. E., Dunstan, David and Subramanian, S V.. (2010). Socioeconomic position, gender, health behaviours and biomarkers of cardiovascular disease and diabetes. Social Science & Medicine. 71(6), pp. 1150 - 1160. https://doi.org/10.1016/j.socscimed.2010.05.038
Neighborhood Disadvantage and Physical Activity: Baseline Results from the HABITAT Multilevel Longitudinal Study
Turrell, Gavin, Haynes, Michele A., Burton, Nicola W., Giles-Corti, Billie, Oldenburg, Brian, Wilson, Lee-Ann, Giskes, Katrina and Brown, Wendy. (2010). Neighborhood Disadvantage and Physical Activity: Baseline Results from the HABITAT Multilevel Longitudinal Study. Annals of Epidemiology. 20(3), pp. 171 - 181. https://doi.org/10.1016/j.annepidem.2009.11.004
Best practice for prevention and treatment of cardiovascular disease through an equity lens: A review
Beauchamp, Allison, Peeters, A., Tonkin, Andrew and Turrell, Gavin. (2010). Best practice for prevention and treatment of cardiovascular disease through an equity lens: A review. European Journal of Preventative Cardiology. 17(5), pp. 599 - 606. https://doi.org/10.1097/HJR.0b013e328339cc99
HABITAT: A longitudinal multilevel study of physical activity change in mid-aged adults
Burton, Nicola W., Haynes, Michele A., Wilson, Lee-Ann, Giles-Corti, Billie, Oldenburg, Brian, Brown, Wendy, Giskes, Katrina and Turrell, Gavin. (2009). HABITAT: A longitudinal multilevel study of physical activity change in mid-aged adults. BMC Public Health. 9(1). https://doi.org/10.1186/1471-2458-9-76
A multilevel study of area socio-economic status and food purchasing behaviour
Turrell, Gavin, Bentley, Rebecca, Thomas, Lyndal R., Jolley, Damien, Subramanian, S. V. and Kavanagh, Anne M.. (2009). A multilevel study of area socio-economic status and food purchasing behaviour. Public Health Nutrition. 12(11), pp. 2074-2083. https://doi.org/10.1017/S1368980009004911
Socioeconomic differences in takeaway food consumption and their contribution to inequalities in dietary intakes
Miura, Kyoko, Giskes, Katrina and Turrell, Gavin. (2009). Socioeconomic differences in takeaway food consumption and their contribution to inequalities in dietary intakes. Journal of Epidemiology and Community Health. 63(10), pp. 820 - 826. https://doi.org/10.1136/jech.2008.086504
Social roles and birthing practices of traditional birth attendants in India with reference to other developing countries
Saravanan, Sheela, Johnson, Helen, Turrell, Gavin and Fraser, Jennifer. (2009). Social roles and birthing practices of traditional birth attendants in India with reference to other developing countries. Asian Journal of Women's Studies. 15(4), pp. 57 - 89. https://doi.org/10.1080/12259276.2009.11666078
Measuring factors that influence the utilisation of preventive care services provided by general practitioners in Australia
Zhang, Jianzhen, Oldenburg, Brian and Turrell, Gavin. (2009). Measuring factors that influence the utilisation of preventive care services provided by general practitioners in Australia. BMC Health Services Research. 9(1). https://doi.org/10.1186/1472-6963-9-218
Affluent neighborhoods reduce excess risk of tooth loss among the poor
Sanders, Anne E., Turrell, Gavin and Slade, Gary D.. (2008). Affluent neighborhoods reduce excess risk of tooth loss among the poor. Journal of Dental Research. 87(10), pp. 969 - 973. https://doi.org/10.1177/154405910808701006
Socioeconomic position at different stages of the life course and its influence on body weight and weight gain in adulthood: A longitudinal study with 13-year follow-up
Giskes, Katrina, van Lenthe, Frank J., Turrell, Gavin, Kamphuis, Carlijn B. M., Brugemann, Johan and Mackenbach, Johan P.. (2008). Socioeconomic position at different stages of the life course and its influence on body weight and weight gain in adulthood: A longitudinal study with 13-year follow-up. Obesity. 16(6), pp. 1377 - 1381. https://doi.org/10.1038/oby.2008.54
Area disadvantage, individual socio-economic position, and premature cancer mortality in Australia 1998 to 2000: A multilevel analysis
Bentley, Rebecca J., Kavanagh, Anne M., Subramanian, S. V. and Turrell, Gavin. (2008). Area disadvantage, individual socio-economic position, and premature cancer mortality in Australia 1998 to 2000: A multilevel analysis. Cancer Causes and Control. 19(2), pp. 183 - 193. https://doi.org/10.1007/s10552-007-9084-7
Socioeconomic disadvantage and the purchase of takeaway food: A multilevel analysis
Turrell, Gavin and Giskes, Katrina. (2008). Socioeconomic disadvantage and the purchase of takeaway food: A multilevel analysis. Appetite. 51(1), pp. 69 - 81. https://doi.org/10.1016/j.appet.2007.12.002
Area variation in recreational cycling in Melbourne: A compositional or contextual effect?
Kamphuis, Carlijn B. M., Giskes, Katrina, Kavanagh, Anne M., Thornton, Lukar, Thomas, Lyndal R., van Lenthe, Frank J., Mackenbach, Johan P. and Turrell, Gavin. (2008). Area variation in recreational cycling in Melbourne: A compositional or contextual effect? Journal of Epidemiology and Community Health. 62(10), pp. 890 - 898. https://doi.org/10.1136/jech.2007.067116
Do places affect the probability of death in Australia? A multilevel study of area-level disadvantage, individual-level socioeconomic position and all-cause mortality, 1998-2000
Turrell, Gavin, Kavanagh, Anne M., Draper, Glenn and Subramanian, S V.. (2007). Do places affect the probability of death in Australia? A multilevel study of area-level disadvantage, individual-level socioeconomic position and all-cause mortality, 1998-2000. Journal of Epidemiology and Community Health. 61(1), pp. 13 - 19. https://doi.org/10.1136/jech.2006.046094
Measuring psychological, social, and environmental influences on leisure-time physical activity among adults
Burton, Nicola W., Turrell, Gavin, Oldenburg, Brian and Sallis, Jim. (2007). Measuring psychological, social, and environmental influences on leisure-time physical activity among adults. Australian and New Zealand Journal of Public Health. 31(1), pp. 36 - 43. https://doi.org/10.1111/j.1753-6405.2007.00008.x
The independent contribution of neighborhood disadvantage and individual-level socioeconomic position to self-reported oral health: A multilevel analysis
Turrell, Gavin, Sanders, Anne E., Slade, Gary D., Spencer, A John and Marcenes, Wagner. (2007). The independent contribution of neighborhood disadvantage and individual-level socioeconomic position to self-reported oral health: A multilevel analysis. Community Dentistry and Oral Epidemiology. 35(3), pp. 195 - 206. https://doi.org/10.1111/j.1600-0528.2006.00311.x
Socioeconomic inequalities in food purchasing: The contribution of respondent-perceived and actual (objectively measured) price and availability of foods
Giskes, Katrina, van Lenthe, Frank J., Mackenbach, Johan P. and Turrell, Gavin. (2007). Socioeconomic inequalities in food purchasing: The contribution of respondent-perceived and actual (objectively measured) price and availability of foods. Preventive Medicine. 45(1), pp. 41 - 48. https://doi.org/10.1016/j.ypmed.2007.04.007
Does psychological stress mediate social deprivation in tooth loss?
Sanders, Anne E., Slade, Gary D., Turrell, Gavin, Spencer, A John and Marcenes, Wagner. (2007). Does psychological stress mediate social deprivation in tooth loss? Journal of Dental Research. 86(12), pp. 1166 - 1170. https://doi.org/10.1177/154405910708601205
Socioeconomic disadvantage in childhood and across the life course and all-cause mortality and physical function in adulthood: Evidence from the Alameda County Study
Turrell, Gavin, Lynch, John, Leite, Claudia, Raghunathan, Trivellore and Kaplan, George A.. (2007). Socioeconomic disadvantage in childhood and across the life course and all-cause mortality and physical function in adulthood: Evidence from the Alameda County Study. Journal of Epidemiology and Community Health. 61(8), pp. 723 - 730. https://doi.org/10.1136/jech.2006.050609
Smokers living in deprived areas are less likely to quit: A longitudinal follow-up
Giskes, Katrina, van Lenthe, Frank J., Turrell, Gavin, Brugemann, Johan and Mackenbach, Johan P.. (2006). Smokers living in deprived areas are less likely to quit: A longitudinal follow-up. Tobacco Control. 15(6), pp. 485 - 488. https://doi.org/10.1136/tc.2006.015750
Weight and place: A multilevel cross-sectional survey of area-level social disadvantage and overweight/obesity in Australia
King, Tania, Kavanagh, Anne M., Jolley, Damien, Turrell, Gavin and Crawford, David. (2006). Weight and place: A multilevel cross-sectional survey of area-level social disadvantage and overweight/obesity in Australia. International Journal of Obesity. 30(2), pp. 281 - 287. https://doi.org/10.1038/sj.ijo.0803176
Does living in a disadvantaged area mean fewer opportunities to purchase fresh fruit and vegetables in the area? Findings from the Brisbane food study
Winkler, Elizabeth A. H., Turrell, Gavin and Patterson, Carla. (2006). Does living in a disadvantaged area mean fewer opportunities to purchase fresh fruit and vegetables in the area? Findings from the Brisbane food study. Health and Place. 12(3), pp. 306 - 319. https://doi.org/10.1016/j.brainresbull.2006.01.003
A multilevel study of socio-economic inequalities in food choice behaviour and dietary intake among the Dutch population : The GLoBE study
Giskes, Katrina, Turrell, Gavin, van Lenthe, Frank J., Brugemann, Johan and Mackenbach, Johan P.. (2006). A multilevel study of socio-economic inequalities in food choice behaviour and dietary intake among the Dutch population : The GLoBE study. Public Health Nutrition. 9(1), pp. 75-83. https://doi.org/10.1079/PHN2005758
Does gender modify associations between self rated health and the social and economic characteristics of local environments?
Kavanagh, Anne M., Bentley, Rebecca J., Turrell, Gavin, Broom, Dorothy H. and Subramanian, S V.. (2006). Does gender modify associations between self rated health and the social and economic characteristics of local environments? Journal of Epidemiology and Community Health. 60(6), pp. 490 - 495. https://doi.org/10.1136/jech.2005.043562
Area variation in mortality in Tasmania (Australia): The contributions of socioeconomic disadvantage, social capital and geographic remoteness
Turrell, Gavin, Kavanagh, Anne M. and Subramanian, S. V.. (2006). Area variation in mortality in Tasmania (Australia): The contributions of socioeconomic disadvantage, social capital and geographic remoteness. Health and Place. 12(3), pp. 291 - 305. https://doi.org/10.1016/j.healthplace.2004.08.012
Socio-economic pathways to diet: Modelling the association between socio-economic position and food purchasing behaviour
Turrell, Gavin and Kavanagh, Anne M.. (2006). Socio-economic pathways to diet: Modelling the association between socio-economic position and food purchasing behaviour. Public Health Nutrition. 9(3), pp. 375 - 383. https://doi.org/10.1079/PHN2006850
Does area-based social capital matter for the health of Australians? A multilevel analysis of self-rated health in Tasmania
Kavanagh, Anne M., Turrell, Gavin and Subramanian, S. V.. (2006). Does area-based social capital matter for the health of Australians? A multilevel analysis of self-rated health in Tasmania. International Journal of Epidemiology. 35(3), pp. 607 - 613. https://doi.org/10.1093/ije/dyl010
The shape of the socioeconomic-oral health gradient: Implications for theoretical explanations
Sanders, Anne E., Slade, Gary D., Turrell, Gavin, Spencer, A John and Marcenes, Wagner. (2006). The shape of the socioeconomic-oral health gradient: Implications for theoretical explanations. Community Dentistry and Oral Epidemiology. 34(4), pp. 310 - 319. https://doi.org/10.1111/j.1600-0528.2006.00286.x
Does living in a disadvantaged area entail limited opportunities to purchase fresh fruit and vegetables in terms of price, availability, and variety? Findings from the Brisbane Food Study
Winkler, Elizabeth A. H., Turrell, Gavin and Patterson, Carla. (2006). Does living in a disadvantaged area entail limited opportunities to purchase fresh fruit and vegetables in terms of price, availability, and variety? Findings from the Brisbane Food Study. Health and Place. 12(4), pp. 741 - 748. https://doi.org/10.1016/j.healthplace.2005.09.006
Urban area disadvantage and physical activity: A multilevel study in Melbourne, Australia
Kavanagh, Anne M., Goller, Jane L., King, Tania, Jolley, Damien, Crawford, David and Turrell, Gavin. (2005). Urban area disadvantage and physical activity: A multilevel study in Melbourne, Australia. Journal of Epidemiology and Community Health. 59(11), pp. 934 - 940. https://doi.org/10.1136/jech.2005.035931
Childhood and Adult Socioeconomic Conditions and 31-Year Mortality Risk in Women
Beene-Dimmer, Jennifer, Lynch, John, Turrell, Gavin, Lustgarten, Stephanie, Raghunathan, Trivellore and Kaplan, George A.. (2004). Childhood and Adult Socioeconomic Conditions and 31-Year Mortality Risk in Women. American Journal of Epidemiology. 159(5), pp. 481 - 490. https://doi.org/10.1093/aje/kwh057
Utilisation of general practitioner services by socio-economic disadvantage and geographic remoteness
Turrell, Gavin, Oldenburg, Brian, Harris, Elizabeth and Jolley, Damien. (2004). Utilisation of general practitioner services by socio-economic disadvantage and geographic remoteness. Australian and New Zealand Journal of Public Health. 28(2), pp. 152 - 158. https://doi.org/10.1111/j.1467-842X.2004.tb00929.x
A multilevel analysis of socioeconomic (small area) differences in household food purchasing behaviour
Turrell, Gavin, Blakely, Tony, Patterson, Carla and Oldenburg, Brian. (2004). A multilevel analysis of socioeconomic (small area) differences in household food purchasing behaviour. Journal of Epidemiology and Community Health. 58(3), pp. 208-215. https://doi.org/10.1136/jech.2003.011031