Female breast cancer in New South Wales, Australia, by country of birth: implications for health-service delivery

NSW has a multicultural population with increasing migration from South East Asia, the Western Pacific and Eastern Mediterranean. To compare cancer stage, treatment (first 12 months) and survival for 12 country of birth (COB) categories recorded on the population-based NSW Cancer Registry. Historic...

Full description

Saved in:

Bibliographic Details
Published in:	BMC public health 2021-02, Vol.21 (1), p.371-371, Article 371
Main Authors:	Roder, David, Zhao, George W, Challam, Sheetal, Little, Alana, Elder, Elisabeth, Kostadinovska, Gordana, Woodland, Lisa, Currow, David
Format:	Article
Language:	eng
Subjects:	Age Aged Australia Birth Birth countries Breast cancer Breast cancer survival Breast Neoplasms - epidemiology Breast Neoplasms - therapy Cancer Cancer therapies Care and treatment Chemotherapy China - epidemiology Cohort Studies Comorbidity Country of birth Demographic aspects Diagnosis Drug therapy End of life Female Germany Government programs Greece Humans International standardization International standards Invasiveness Italy Lebanon - epidemiology Mastectomy Medicare Mortality National Health Programs New South Wales New South Wales - epidemiology Patient outcomes Pharmaceuticals Philippines Population Radiation therapy Regression analysis Socioeconomic factors Surgery Survival United Kingdom Vietnam - epidemiology Womens health
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	NSW has a multicultural population with increasing migration from South East Asia, the Western Pacific and Eastern Mediterranean. To compare cancer stage, treatment (first 12 months) and survival for 12 country of birth (COB) categories recorded on the population-based NSW Cancer Registry. Historic cohort study of invasive breast cancers diagnosed in 2003-2016. Data for 48,909 women (18+ ages) analysed using linked cancer registry, hospital inpatient and Medicare and pharmaceutical benefits claims data. Comparisons by COB using multivariate logistic regression and proportional hazards regression with follow-up of vital status to April 30th, 2020. Compared with the Australia-born, women born in China, the Philippines, Vietnam and Lebanon were younger at diagnosis, whereas those from the United Kingdom, Germany, Italy and Greece were older. Women born in China, the Philippines, Vietnam, Greece and Italy lived in less advantaged areas. Adjusted analyses indicated that: (1) stage at diagnosis was less localised for women born in Germany, Greece, Italy and Lebanon; (2) a lower proportion reported comorbidity for those born in China, the Philippines and Vietnam; (3) surgery type varied, with mastectomy more likely for women born in China, the Philippines and Vietnam, and less likely for women born in Italy, Greece and Lebanon; (4) radiotherapy was more likely where breast conserving surgery was more common (Greece, Italy, and Lebanon) and the United Kingdom; and (5) systemic drug therapy was less common for women born in China and Germany. Five-year survival in NSW was high by international standards and increasing. Adjusted analyses indicate that, compared with the Australian born, survival from death from cancer at 5 years from diagnosis was higher for women born in China, the Philippines, Vietnam, Italy, the United Kingdom and Greece. There is diversity by COB of stage, treatment and survival. Reasons for survival differences may include cultural factors and healthier migrant populations with lower comorbidity, and potentially, less complete death recording in Australia if some women return to their birth countries for treatment and end-of-life care. More research is needed to explore the cultural and clinical factors that health services need to accommodate.
ISSN:	1471-2458 1471-2458