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Dialla P.O.,Center Georges Francois Leclerc Comprehensive Cancer Center | Dialla P.O.,University of Burgundy | Arveux P.,Center Georges Francois Leclerc Comprehensive Cancer Center | Arveux P.,University of Burgundy | And 12 more authors.
European Journal of Public Health | Year: 2015

Background: This study aimed to determine the impact of socio-economic and geographic disparities on disease stage at diagnosis according to age in breast cancer (BC) patients. Secondary purpose was to describe survival. Methods: All women with primary invasive BC, diagnosed from 1998 to 2009 in the department of Cô te dOr were retrospectively selected using data from the Cô te dOr BC registry. European transnational ecological deprivation index (French European Deprivation Index) was used to measure the socio-economic environment. Relationships between socio-geographic deprivation and disease stage at diagnosis according to age were assessed by a multilevel ordered logistic regression model. Relative survival rates (RSRs) were given at 5 years according to tumour and patients characteristics. Results: In total, 4364 women were included. In multivariable analysis, socio-economic deprivation was associated with disease stage at diagnosis. Women aged between 50 and 74 years and living in deprived areas were more often diagnosed with advanced tumour stages (stages II/III vs. I or stages IV vs. II/III) with odds ratio = 1.27 (1.011.60). RSRs were lowest in women living in the most deprived area compared with those living in most affluent area with RSR = 88.4% (85.990.4) and 92.6% (90.594.2), respectively. Conclusions: Socio-economic factors affected tumour stage at diagnosis and survival. Living in a deprived area was linked to advanced-stage BC at diagnosis only in women aged 5074 years. This is probably due to the socioeconomic disparities in participation in organized BC screening programmes. Furthermore, living in deprived area was associated with a poor survival rate. © The Author 2015. Source


Dialla P.O.,Center Georges Francois Leclerc Comprehensive Cancer Center | Dialla P.O.,University of Burgundy | Chu W.-O.,Center Georges Francois Leclerc Comprehensive Cancer Center | Chu W.-O.,University of Burgundy | And 9 more authors.
Maturitas | Year: 2015

Objectives: The main purpose of this study was to identify age-related socioeconomic and clinical determinants of quality of life among breast cancer survivors five years after the diagnosis. The secondary objective was to describe quality of life in the studied population according to age. Study design: A cross-sectional survey in five-year breast cancer survivors was conducted in women diagnosed with breast cancer in 2007 and 2008 in Côte d'Or. Main outcome measures: Quality of life was assessed with the SF-12, the EORTC-QLQ-C30 and the EORTC-QLQ-BR23 questionnaires. Socio-economic deprivation was assessed by the EPICES questionnaire. Social support was assessed by the Sarason questionnaire and clinical features were collected through the Côte d'Or breast cancer registry. Age-related determinants of quality of life were identified using multivariate mixed model analysis for each SF-12 dimension. Results: Overall 396 women completed the questionnaires. Women aged <65 years had a better quality of life and a greater availability of social support than did women aged ≥65 years. Body mass index, relapse and EPICES were found to be determinants of quality of life in younger women (p < 0.006). For older women, comorbidities and EPICES deprivation scores were predictors of low quality of life scores (p < 0.006). Conclusions: Five years after breast cancer diagnosis, disease severity did not affect quality of life. The major determinants of quality of life in younger women were disease relapse and EPICES deprivation scores while those in older women were comorbidities and EPICES deprivation scores. © 2015 Elsevier Ireland Ltd. All rights reserved. Source


Chu W.-O.,Center Georges Francois Leclerc Comprehensive Cancer Center | Chu W.-O.,University of Burgundy | Dialla P.O.,Center Georges Francois Leclerc Comprehensive Cancer Center | Dialla P.O.,University of Burgundy | And 10 more authors.
Quality of Life Research | Year: 2016

Purpose: To identify the impact of clinical and socio-economic determinants on quality of life (QoL) among breast cancer (BC) survivors 5 years after diagnosis. Methods: A cross-sectional survey was conducted in women diagnosed in 2007 for primary invasive non-metastatic BC and identified through the Côte d’Or BC registry. QoL was assessed with the Medical Outcomes Study 12-item Short Form Health Survey (SF-12), the European Organization for Research and Treatment of Cancer Quality of Life (EORTC-QLQ-C30) and the breast cancer (EORTC-QLQ-BR23) questionnaires. Social support was assessed with Sarason’s social support questionnaire, and deprivation was assessed by the EPICES questionnaire. Clinical variables were collected through the registry database. Determinants of QoL were identified using multivariable mixed model analysis for each SF-12 dimension. A sensitivity analysis was conducted with multiple imputations on missing data. Results: Overall, 188 patients on 319 patients (59 %) invited to participate to the survey completed the questionnaires. Five years after breast cancer diagnosis, the disease stages at diagnosis, as well as the treatment received, were not determinants of QoL. Only the age at diagnosis and comorbidities were found to be determinants of QoL. Conclusions: Five years after BC diagnosis, disease severity and the treatment received did not affect QoL. © 2016, Springer International Publishing Switzerland. Source


Dialla P.O.,Center Georges Francois Leclerc Comprehensive Cancer Center | Dialla P.O.,University of Burgundy | Quipourt V.,Coordination Unit in Geriatric Oncology in Burgundy | Gentil J.,Center Georges Francois Leclerc Comprehensive Cancer Center | And 11 more authors.
Geriatrics and Gerontology International | Year: 2015

Aim: The present study aimed to describe treatments, relative survival and prognostic factors in breast cancer patients according to age. Methods: All women with primary invasive breast cancer, diagnosed from 1998 to 2009 in the department of Côte d'Or, were retrospectively selected. Variations in treatments administered according to age (<50years, 50-74years, >74years) and period were assessed using Cochran-Armitage trend tests and χ2-tests, respectively. Prognostic factors according to age were estimated using a generalized linear model with a Poisson error structure. Results: Overall, 4305 women were included. The oldest women (aged >74years) were more likely than the youngest women to have comorbidities, advanced stage tumors, hormone receptor-positive tumors and be human epidermal growth factor receptor2-negative. The use of breast conserving surgery plus adjuvant therapy decreased in older women (>74years), whereas the proportions of women without treatments and with adjuvant hormone therapy increased with age. Multivariate relative survival analyses according to age showed an increased risk of death in women aged 50-74years and >74years with comorbidities compared with those without comorbidities; relative excess risks were 1.85 (1.13-3.02) and 3.23 (1.26-8.31), respectively. In contrast, a decreased risk of death was observed in women aged 50-74years diagnosed by medical imaging compared with those diagnosed by clinical signs; relative excess risks 0.44 (0.22-0.89). Conclusion: Elderly women compared with the youngest women were diagnosed with more favorable tumor biology (hormone receptor-positive tumors, human epidermal growth factor receptor2-negative). However, survival was poor in elderly women who had comorbid conditions, did not attend screening mammography examinations and were undertreated. © 2014 Japan Geriatrics Society. Source

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