01.12.2017 | Research article | Ausgabe 1/2017 Open Access

Do pre-diagnosis primary care consultation patterns explain deprivation-specific differences in net survival among women with breast cancer? An examination of individually-linked data from the UK West Midlands cancer registry, national screening programme and Clinical Practice Research Datalink
- Zeitschrift:
- BMC Cancer > Ausgabe 1/2017
Electronic supplementary material
Background
Methods
Data sources and study population
Variables
Deprivation
Other covariables
Primary care consultations
Statistical analysis
Results
Sample
Consultation rate
Associations between co-variables and deprivation
Total
|
Least deprived
|
2
|
3
|
4
|
Most deprived
|
p-value
a
|
|
---|---|---|---|---|---|---|---|
n (%)
|
n (%)
|
n (%)
|
n (%)
|
n (%)
|
n (%)
|
||
Total
|
786 (100)
|
211 (100)
|
213 (100)
|
140 (100)
|
112 (100)
|
110 (100)
|
|
Vital status at end of follow up
|
|||||||
Alive
|
567 (72.1)
|
165 (78.2)
|
154 (72.3)
|
106 (75.7)
|
76 (67.9)
|
66 (60.0)
|
0.008
|
Dead
|
219 (27.9)
|
46 (21.8)
|
59 (27.7)
|
34 (24.3)
|
36 (32.1)
|
44 (40.0)
|
|
Age groups
|
|||||||
50–54
|
191 (24.3)
|
49 (23.2)
|
57 (26.8)
|
29 (20.7)
|
27 (24.1)
|
29 (26.4)
|
0.707
|
55–59
|
174 (22.1)
|
48 (22.7)
|
48 (22.5)
|
35 (25.0)
|
21 (18.8)
|
22 (20.0)
|
|
60–64
|
216 (27.5)
|
66 (31.3)
|
58 (27.2)
|
33 (23.6)
|
33 (29.5)
|
26 (23.6)
|
|
65–70
|
205 (26.1)
|
48 (22.7)
|
50 (23.5)
|
43 (30.7)
|
31 (27.7)
|
33 (30.0)
|
|
Extent of disease at diagnosis
|
|||||||
Localised
|
437 (55.6)
|
127 (60.2)
|
118 (55.4)
|
81 (57.9)
|
59 (52.7)
|
52 (47.3)
|
0.045
|
Regional
|
255 (32.4)
|
64 (30.3)
|
65 (30.5)
|
45 (32.1)
|
39 (34.8)
|
42 (38.2)
|
|
Distant
|
24 (3.1)
|
3 (1.4)
|
5 (2.3)
|
3 (2.1)
|
4 (3.6)
|
9 (8.2)
|
|
Missing
|
70 (8.9)
|
17 (8.1)
|
25 (11.7)
|
11 (7.9)
|
10 (8.9)
|
7 (6.4)
|
|
Screening groups
|
|||||||
Screen-detected cancer
|
316 (40.2)
|
112 (53.1)
|
119 (55.9)
|
64 (45.7)
|
65 (58.0)
|
74 (67.3)
|
0.013
|
Not screen-detected cancer
|
434 (55.2)
|
91 (43.1)
|
83 (39.0)
|
67 (47.9)
|
45 (40.2)
|
30 (27.3)
|
|
Missing
|
36 (4.6)
|
8 (3.8)
|
11 (5.2)
|
9 (6.4)
|
2 (1.8)
|
6 (5.5)
|
|
Period of diagnosis
|
|||||||
1989–1994
|
81 (10.3)
|
18 (8.5)
|
22 (10.3)
|
13 (9.3)
|
11 (9.8)
|
17 (15.5)
|
0.011
|
1995–2000
|
283 (36.0)
|
79 (37.4)
|
64 (30.0)
|
57 (40.7)
|
32 (28.6)
|
51 (46.4)
|
|
2001–2006
|
422 (53.7)
|
114 (54.0)
|
127 (59.6)
|
70 (50.0)
|
69 (61.6)
|
42 (38.2)
|
|
Smoking status
|
|||||||
Non- or ex-smoker
|
541 (68.8)
|
159 (75.4)
|
154 (72.3)
|
94 (67.1)
|
74 (66.1)
|
60 (54.5)
|
0.002
|
Current smoker
|
222 (28.2)
|
45 (21.3)
|
55 (25.8)
|
42 (30.0)
|
33 (29.5)
|
47 (42.7)
|
|
Missing
|
23 (2.9)
|
7 (3.3)
|
4 (1.9)
|
4 (2.9)
|
5 (4.5)
|
3 (2.7)
|
|
Alcohol consumption status
|
|||||||
Non-drinker
|
84 (10.7)
|
17 (8.1)
|
13 (6.1)
|
19 (13.6)
|
12 (10.7)
|
23 (20.9)
|
<0.001
|
Current drinker
|
569 (72.4)
|
161 (76.3)
|
171 (80.3)
|
96 (68.6)
|
72 (64.3)
|
69 (62.7)
|
|
Ex-drinker
|
81 (10.3)
|
19 (9.0)
|
16 (7.5)
|
14 (10.0)
|
18 (16.1)
|
14 (12.7)
|
|
Missing
|
52 (6.6)
|
14 (6.6)
|
13 (6.1)
|
11 (7.9)
|
10 (8.9)
|
4 (3.6)
|
|
BMI (kg/m
2)
|
|||||||
< 25 kg/m
2
|
305 (38.8)
|
84 (39.8)
|
99 (46.5)
|
53 (37.9)
|
40 (35.7)
|
29 (26.4)
|
0.001
|
25 to <30
|
235 (29.9)
|
73 (34.6)
|
50 (23.5)
|
43 (30.7)
|
32 (28.6)
|
37 (33.6)
|
|
30+
|
189 (24)
|
41 (19.4)
|
49 (23.0)
|
29 (20.7)
|
32 (28.6)
|
38 (34.5)
|
|
Missing
|
57 (7.3)
|
13 (6.2)
|
15 (7.0)
|
15 (10.7)
|
8 (7.1)
|
6 (5.5)
|
|
Charlson score
|
|||||||
0
|
684 (87)
|
191 (90.5)
|
185 (86.9)
|
124 (88.6)
|
93 (83.0)
|
91 (82.7)
|
0.202
|
1+
|
102 (13)
|
20 (9.5)
|
28 (13.1)
|
16 (11.4)
|
19 (17.0)
|
19 (17.3)
|
Total
|
Least deprived
|
2
|
3
|
4
|
Most deprived
|
p-value
a
|
|
---|---|---|---|---|---|---|---|
n (%)
|
n (%)
|
n (%)
|
n (%)
|
n (%)
|
n (%)
|
||
Total
|
434 (100)
|
112(100)
|
119 (100)
|
64 (100)
|
65 (100)
|
74 (100)
|
|
Number of distinct breast symptoms reported in 18mths before diagnosis
|
|||||||
0
|
103 (23.7)
|
37 (33.0)
|
22 (18.5)
|
12 (18.8)
|
16 (24.6)
|
16 (21.6)
|
0.137
|
1
|
278 (64.1)
|
66 (58.9)
|
77 (64.7)
|
45 (70.3)
|
39 (60.0)
|
51 (68.9)
|
|
2+
|
53 (12.2)
|
9 (8.0)
|
20 (16.8)
|
7 (10.9)
|
10 (15.4)
|
7 (9.5)
|
|
Lump symptom
|
|||||||
No
|
137 (31.6)
|
43 (38.4)
|
38 (31.9)
|
11 (17.2)
|
22 (33.9)
|
23 (31.1)
|
0.069
|
Yes
|
297 (68.4)
|
69 (61.6)
|
81 (68.1)
|
53 (82.8)
|
43 (66.2)
|
51 (68.9)
|
Net survival by deprivation
Net survival by covariables
Time from last breast-related consultation to diagnosis and from diagnosis to surgery
Time from last breast-related consultation to diagnosis
|
Time from diagnosis to surgery
|
|||||
---|---|---|---|---|---|---|
N (%)
|
Mean (range), days
|
P value (trend)
|
N (%)
|
Mean (range), days
|
P value (trend)
a
|
|
Total
|
331 (100.0)
|
16.0 (1–509)
|
212 (100.0)
|
23.7 (1–199)
|
||
Deprivation
|
||||||
Least deprived
|
75 (22.7)
|
15.6 (1–444)
|
0.299
|
48 (22.6)
|
22.1 (7–117)
|
0.034
|
2
|
97 (29.3)
|
15.1 (1–509)
|
59 (27.8)
|
21.5 (3–156)
|
||
3
|
52 (15.7)
|
15.8 (2–116)
|
34 (16.0)
|
20.9 (1–162)
|
||
4
|
49 (14.8)
|
15.0 (2–373)
|
35 (16.5)
|
27.6 (13–136)
|
||
Most deprived
|
58 (17.5)
|
19.3 (1–389)
|
36 (17.0)
|
29.2 (10–199)
|
||
Extent
|
||||||
1
|
162 (48.9)
|
14.6 (1–444)
|
0.554
|
110 (51.9)
|
22.0 (3–139)
|
0.137
|
2
|
134 (40.5)
|
17.2 (1–509)
|
89 (42.0)
|
24.3 (1–199)
|
||
3
|
12 (3.6)
|
13.9 (2–222)
|
4 (1.9)
|
48.5 (22–156)
|
||
missing
|
23 (6.9)
|
9 (4.2)
|
||||
Age
|
||||||
50–54
|
89 (26.9)
|
19.4 (1–509)
|
0.144
|
59 (27.8)
|
21.8 (2–162)
|
0.790
|
55–59
|
62 (18.7)
|
14.6 (1–258)
|
45 (21.2)
|
25.2 (3–153)
|
||
60–64
|
89 (26.9)
|
15.9 (2–109)
|
54 (25.5)
|
23.9 (1–151)
|
||
65–70
|
91 (27.5)
|
14.1 (1–389)
|
54 (25.5)
|
24.3 (6–199)
|
||
BMI
|
||||||
< 25 normal
|
141 (42.6)
|
15.0 (1–444)
|
0.235
|
85 (40.1)
|
21.3 (2–199)
|
0.590
|
25to < 30 overweight
|
97 (29.3)
|
14.5 (1–509)
|
68 (32.1)
|
26.7 (7–156)
|
||
30+ obese
|
68 (20.5)
|
20.1 (4–444)
|
49 (23.1)
|
22.4 (1–162)
|
||
missing
|
25 (7.6)
|
10 (4.7)
|
||||
Smoking
|
||||||
non- or ex-smoker
|
219 (66.2)
|
15.4 (1–509)
|
0.371
|
142 (67.0)
|
23.4 (1–156)
|
0.881
|
current smoker
|
102 (30.8)
|
17.5 (1–258)
|
64 (30.2)
|
24.3 (3–199)
|
||
missing
|
10 (3.0)
|
6 (2.8)
|
||||
Alcohol consumption status
|
||||||
non-drinker
|
37 (11.2)
|
14.0 (2–101)
|
0.989
|
26 (12.3)
|
21.6 (11–53)
|
0.857
|
current drinker
|
242 (73.1)
|
16.4 (1–509)
|
155 (73.1)
|
24.1 (1–199)
|
||
ex-drinker
|
33 (10.0)
|
15.4 (2–393)
|
23 (10.8)
|
21.3 (6–106)
|
||
missing
|
19 (5.7)
|
8 (3.8)
|
||||
Charlson score
|
||||||
0
|
298 (90.0)
|
15.8 (1–509)
|
0.414
|
188 (88.7)
|
23.1 (1–199)
|
0.103
|
1+
|
33 (10.0)
|
17.4 (2–109)
|
24 (11.3)
|
28.9 (12–106)
|
||
Lump symptom
|
||||||
No
|
59 (17.8)
|
20.0 (1–444)
|
0.206
|
35 (16.5)
|
23.1 (3–199)
|
0.827
|
Yes
|
272 (82.2)
|
15.2 (1–509)
|
177 (83.5)
|
23.8 (1–162)
|