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dc.contributor.authorMesa-Eguiagaray, Ines
dc.contributor.authorWild, Sarah H
dc.contributor.authorBird, Sheila M
dc.contributor.authorWilliams, Linda J
dc.contributor.authorBrewster, David H
dc.contributor.authorHall, Peter S
dc.contributor.authorFigueroa, Jonine D
dc.date.accessioned2022-06-29T19:50:47Z
dc.date.available2022-06-29T19:50:47Z
dc.date.issued2022-06-01
dc.date.submitted2022-01-25
dc.identifier.issn0167-6806
dc.identifier.others10549-022-06632-1
dc.identifier.other6632
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/338613
dc.description.abstractBACKGROUND: Women from socio-economically deprived areas are less likely to develop and then to survive breast cancer (BC). Whether associations between deprivation and BC incidence and survival differ by tumour molecular subtypes and mode of detection in Scotland are unknown. METHODS: Data consisted of 62,378 women diagnosed with invasive BC between 2000 and 2016 in Scotland. Incidence rates and time trends were calculated for oestrogen receptor positive (ER+) and negative (ER-) tumours and stratified by the Scottish Index of Multiple Deprivation (SIMD) quintiles and screening status. SIMD is an area-based measure derived across seven domains: income, employment, education, health, access to services, crime and housing. We calculated adjusted hazard ratios (aHR [95% confidence intervals]) for BC death by immunohistochemical surrogates of molecular subtypes for the most versus the least deprived quintile. We adjusted for mode of detection and other confounders. RESULTS: In Scotland, screen-detected ER+tumour incidence increased over time, particularly in the least deprived quintile [Average Annual Percentage Change (AAPC) = 2.9% with 95% CI from 1.2 to 4.7]. No marked differences were observed for non-screen-detected ER+tumours or ER- tumours by deprivation. BC mortality was higher in the most compared to the least deprived quintile irrespective of ER status (aHR = 1.29 [1.18, 1.41] for ER+ and 1.27 [1.09, 1.47] for ER- tumours). However, deprivation was associated with significantly higher mortality for luminal A and HER2-enriched tumours (aHR = 1.46 [1.13, 1.88] and 2.10 [1.23, 3.59] respectively) but weaker associations for luminal B and TNBC tumours that were not statistically significant. CONCLUSIONS: Deprivation is associated with differential BC incidence trends for screen-detected ER+tumours and with higher mortality for select tumour subtypes. Future efforts should evaluate factors that might be associated with reduced survival in deprived populations and monitor progress stratified by tumour subtypes and mode of detection.
dc.languageen
dc.publisherSpringer Science and Business Media LLC
dc.subjectEpidemiology
dc.subjectBreast cancer
dc.subjectIncidence
dc.subjectMortality
dc.subjectSubtypes
dc.subjectSocio-economic status
dc.titleBreast cancer incidence and survival in Scotland by socio-economic deprivation and tumour subtype.
dc.typeArticle
dc.date.updated2022-06-29T19:50:47Z
prism.endingPage473
prism.issueIdentifier2
prism.publicationNameBreast Cancer Res Treat
prism.startingPage463
prism.volume194
dc.identifier.doi10.17863/CAM.86026
dcterms.dateAccepted2022-05-09
rioxxterms.versionofrecord10.1007/s10549-022-06632-1
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
dc.contributor.orcidMesa-Eguiagaray, Ines [0000-0002-6784-2419]
dc.contributor.orcidFigueroa, Jonine D. [0000-0002-5100-623X]
dc.identifier.eissn1573-7217
pubs.funder-project-idWellcome Trust (207800/Z/17/Z)
cam.issuedOnline2022-06-01


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