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Type: Journal article
Title: Survival from breast cancer: an analysis of Australian data by surgeon case load, treatment centre location, and health insurance status
Author: Roder, D.
De Silva, P.
Zorbas, H.
Kollias, J.
Malycha, P.
Pyke, C.
Campbell, I.
Citation: Australian Health Review, 2012; 36(3):342-348
Publisher: Australian Healthcare Association
Issue Date: 2012
ISSN: 0156-5788
Statement of
David Roder, Primali de Silva, Helen M. Zorbas, James Kollias, Peter L. Malycha, Chris M. Pyke and Ian D. Campbell
Abstract: OBJECTIVE: Early invasive breast cancer data from the Australian National Breast Cancer Audit were used to compare case fatality by surgeon case load, treatment centre location and health insurance status. METHOD: Deaths were traced to 31 December 2007, for cancers diagnosed in 1998–2005. Risk of breast cancer death was compared using Cox proportional hazards regression. RESULTS: When adjustment was made for age and clinical risk factors: (i) the relative risk of breast cancer death (95% confidence limit) was lower whensurgeons’ annual case loads exceeded 20 cases, at 0.87 (0.76, 0.995) for 21–100 cases and 0.83 (0.72, 0.97) for higher case loads. These relative risks were not statistically significant when also adjusting for treatment centre location (P_0.15); and (ii) compared with major city centres, inner regional centres had a relative risk of 1.32 (1.18, 1.48), but the risk was not elevated for more remote sites at 0.95 (0.74, 1.22). Risk of death was not related to private insurance status. CONCLUSION: Higher breast cancer mortality in patients treated in inner regional than major city centres and in those treated by surgeons with lower case loads requires further study.
Keywords: Humans
Breast Neoplasms
Proportional Hazards Models
Aged, 80 and over
Middle Aged
Insurance Coverage
Insurance, Health
Professional Practice Location
General Surgery
Young Adult
Rights: © AHHA 2012
DOI: 10.1071/AH11060
Appears in Collections:Aurora harvest
Surgery publications

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