The importance of location in determining breast conservation rates
This study evaluates differences in the utilization of breast conservation surgery (BCS) between major metropolitan areas in the United States (US) and the United Kingdom (UK). Surgical and staging information were obtained from the Cancer Surveillance Program for Los Angeles County (LAC), the New Y...
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| Veröffentlicht in: | The American journal of surgery 2005-07, Vol.190 (1), p.18-22 |
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| creator | Hiotis, Karen Ye, Wei Sposto, Richard Goldberg, Judith Mukhi, Vandana Skinner, Kristin |
| description | This study evaluates differences in the utilization of breast conservation surgery (BCS) between major metropolitan areas in the United States (US) and the United Kingdom (UK).
Surgical and staging information were obtained from the Cancer Surveillance Program for Los Angeles County (LAC), the New York State (NYS) Department of Health Cancer Registry, and the UK National Health Service (NHS) Breast Screening Program. Demographic data were obtained from the census databases from the US, UK, Northern Ireland, and Scotland. Descriptive statistics, correlation analysis, and chi-square tests were used to compare rates of BCS across the locations under study.
Breast conservation rates were highest in London (79.3%) compared to New York City (NYC) (69.7%) and LAC (66.5%) (
P < .0001). Both in NYS and the UK, the cities differ from the surrounding regions in population density, education levels, agricultural activities, and unemployment. BCS rates tended to increase with population density and education levels, and decrease with increased unemployment and agricultural activity, but there was no impact on BCS rates when adjustments for these variables were included in regression models. BCS rates increase with increasing hospital case volume in LAC and NYC (
P < .0001).
When comparing large metropolitan areas in the US and UK there are significantly different rates of BCS in different locations. These differences reflect differences in population density, socioeconomic status (SES), education levels, hospital volume, and the effects of a nationally funded screening program. |
| doi_str_mv | 10.1016/j.amjsurg.2004.12.002 |
| format | Article |
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Surgical and staging information were obtained from the Cancer Surveillance Program for Los Angeles County (LAC), the New York State (NYS) Department of Health Cancer Registry, and the UK National Health Service (NHS) Breast Screening Program. Demographic data were obtained from the census databases from the US, UK, Northern Ireland, and Scotland. Descriptive statistics, correlation analysis, and chi-square tests were used to compare rates of BCS across the locations under study.
Breast conservation rates were highest in London (79.3%) compared to New York City (NYC) (69.7%) and LAC (66.5%) (
P < .0001). Both in NYS and the UK, the cities differ from the surrounding regions in population density, education levels, agricultural activities, and unemployment. BCS rates tended to increase with population density and education levels, and decrease with increased unemployment and agricultural activity, but there was no impact on BCS rates when adjustments for these variables were included in regression models. BCS rates increase with increasing hospital case volume in LAC and NYC (
P < .0001).
When comparing large metropolitan areas in the US and UK there are significantly different rates of BCS in different locations. These differences reflect differences in population density, socioeconomic status (SES), education levels, hospital volume, and the effects of a nationally funded screening program.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2004.12.002</identifier><identifier>PMID: 15972165</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Attitude of Health Personnel ; Biological and medical sciences ; Breast cancer ; Breast conservation ; Breast Neoplasms - mortality ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; Cancer surgery ; Cancer therapies ; Censuses ; Confidence Intervals ; Demographics ; Economic conditions ; Education ; Female ; General aspects ; Health Care Surveys ; Humans ; Incidence ; Labor force ; Linear Models ; Mastectomy, Segmental - methods ; Mastectomy, Segmental - statistics & numerical data ; Medical sciences ; Neoplasm Invasiveness - pathology ; Neoplasm Staging ; Odds Ratio ; Patient Selection ; Population Density ; Practice Patterns, Physicians ; Probability ; Radiation therapy ; Registries ; Risk Assessment ; Socioeconomic factors ; Studies ; Surgery ; Survival Rate ; Teaching hospitals ; Therapy ; Treatment Outcome ; Unemployment ; United Kingdom ; United States</subject><ispartof>The American journal of surgery, 2005-07, Vol.190 (1), p.18-22</ispartof><rights>2005 Excerpta Medica Inc.</rights><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c421t-6ed43e7dbf937ebcc53ceaf80a3dce590c7ee797f0dd1089926df8b1245b77bd3</citedby><cites>FETCH-LOGICAL-c421t-6ed43e7dbf937ebcc53ceaf80a3dce590c7ee797f0dd1089926df8b1245b77bd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002961005003314$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16927046$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15972165$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hiotis, Karen</creatorcontrib><creatorcontrib>Ye, Wei</creatorcontrib><creatorcontrib>Sposto, Richard</creatorcontrib><creatorcontrib>Goldberg, Judith</creatorcontrib><creatorcontrib>Mukhi, Vandana</creatorcontrib><creatorcontrib>Skinner, Kristin</creatorcontrib><title>The importance of location in determining breast conservation rates</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>This study evaluates differences in the utilization of breast conservation surgery (BCS) between major metropolitan areas in the United States (US) and the United Kingdom (UK).
Surgical and staging information were obtained from the Cancer Surveillance Program for Los Angeles County (LAC), the New York State (NYS) Department of Health Cancer Registry, and the UK National Health Service (NHS) Breast Screening Program. Demographic data were obtained from the census databases from the US, UK, Northern Ireland, and Scotland. Descriptive statistics, correlation analysis, and chi-square tests were used to compare rates of BCS across the locations under study.
Breast conservation rates were highest in London (79.3%) compared to New York City (NYC) (69.7%) and LAC (66.5%) (
P < .0001). Both in NYS and the UK, the cities differ from the surrounding regions in population density, education levels, agricultural activities, and unemployment. BCS rates tended to increase with population density and education levels, and decrease with increased unemployment and agricultural activity, but there was no impact on BCS rates when adjustments for these variables were included in regression models. BCS rates increase with increasing hospital case volume in LAC and NYC (
P < .0001).
When comparing large metropolitan areas in the US and UK there are significantly different rates of BCS in different locations. These differences reflect differences in population density, socioeconomic status (SES), education levels, hospital volume, and the effects of a nationally funded screening program.</description><subject>Attitude of Health Personnel</subject><subject>Biological and medical sciences</subject><subject>Breast cancer</subject><subject>Breast conservation</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>Cancer surgery</subject><subject>Cancer therapies</subject><subject>Censuses</subject><subject>Confidence Intervals</subject><subject>Demographics</subject><subject>Economic conditions</subject><subject>Education</subject><subject>Female</subject><subject>General aspects</subject><subject>Health Care Surveys</subject><subject>Humans</subject><subject>Incidence</subject><subject>Labor force</subject><subject>Linear Models</subject><subject>Mastectomy, Segmental - methods</subject><subject>Mastectomy, Segmental - statistics & numerical data</subject><subject>Medical sciences</subject><subject>Neoplasm Invasiveness - pathology</subject><subject>Neoplasm Staging</subject><subject>Odds Ratio</subject><subject>Patient Selection</subject><subject>Population Density</subject><subject>Practice Patterns, Physicians</subject><subject>Probability</subject><subject>Radiation therapy</subject><subject>Registries</subject><subject>Risk Assessment</subject><subject>Socioeconomic factors</subject><subject>Studies</subject><subject>Surgery</subject><subject>Survival Rate</subject><subject>Teaching hospitals</subject><subject>Therapy</subject><subject>Treatment Outcome</subject><subject>Unemployment</subject><subject>United Kingdom</subject><subject>United States</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqF0V1r3SAYwHEpLetZt4-wESjdXTIfTTRelXHoXqCwm-5ajD5pDUk81aTQbz_LCRR60ytRfo_IX0K-AK2Agvg-VGYa0hrvK0ZpXQGrKGUnZAetVCW0LT8lO5qPSiWAnpOPKQ15C1DzD-QcGiUZiGZH9ncPWPjpEOJiZotF6IsxWLP4MBd-LhwuGCc_-_m-6CKatBQ2zAnj05FEs2D6RM56Myb8vK0X5N_Pm7v97_L2768_-x-3pa0ZLKVAV3OUrusVl9hZ23CLpm-p4c5io6iViFLJnjoHtFWKCde3HbC66aTsHL8g3473HmJ4XDEtevLJ4jiaGcOatJBKUMVohpdv4BDWOOe3aaAcGG0lb7NqjsrGkFLEXh-in0x8zki_NNaD3hrrl8YamM5B89zX7fa1m9C9Tm1RM7jagEnWjH3MZX16dUIxSWuR3fXRYY725DHqZD3mX3A-ol20C_6dp_wH6ladVQ</recordid><startdate>20050701</startdate><enddate>20050701</enddate><creator>Hiotis, Karen</creator><creator>Ye, Wei</creator><creator>Sposto, Richard</creator><creator>Goldberg, Judith</creator><creator>Mukhi, Vandana</creator><creator>Skinner, Kristin</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20050701</creationdate><title>The importance of location in determining breast conservation rates</title><author>Hiotis, Karen ; Ye, Wei ; Sposto, Richard ; Goldberg, Judith ; Mukhi, Vandana ; Skinner, Kristin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c421t-6ed43e7dbf937ebcc53ceaf80a3dce590c7ee797f0dd1089926df8b1245b77bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Attitude of Health Personnel</topic><topic>Biological and medical sciences</topic><topic>Breast cancer</topic><topic>Breast conservation</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>Cancer surgery</topic><topic>Cancer therapies</topic><topic>Censuses</topic><topic>Confidence Intervals</topic><topic>Demographics</topic><topic>Economic conditions</topic><topic>Education</topic><topic>Female</topic><topic>General aspects</topic><topic>Health Care Surveys</topic><topic>Humans</topic><topic>Incidence</topic><topic>Labor force</topic><topic>Linear Models</topic><topic>Mastectomy, Segmental - methods</topic><topic>Mastectomy, Segmental - statistics & numerical data</topic><topic>Medical sciences</topic><topic>Neoplasm Invasiveness - pathology</topic><topic>Neoplasm Staging</topic><topic>Odds Ratio</topic><topic>Patient Selection</topic><topic>Population Density</topic><topic>Practice Patterns, Physicians</topic><topic>Probability</topic><topic>Radiation therapy</topic><topic>Registries</topic><topic>Risk Assessment</topic><topic>Socioeconomic factors</topic><topic>Studies</topic><topic>Surgery</topic><topic>Survival Rate</topic><topic>Teaching hospitals</topic><topic>Therapy</topic><topic>Treatment Outcome</topic><topic>Unemployment</topic><topic>United Kingdom</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hiotis, Karen</creatorcontrib><creatorcontrib>Ye, Wei</creatorcontrib><creatorcontrib>Sposto, Richard</creatorcontrib><creatorcontrib>Goldberg, Judith</creatorcontrib><creatorcontrib>Mukhi, Vandana</creatorcontrib><creatorcontrib>Skinner, Kristin</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hiotis, Karen</au><au>Ye, Wei</au><au>Sposto, Richard</au><au>Goldberg, Judith</au><au>Mukhi, Vandana</au><au>Skinner, Kristin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The importance of location in determining breast conservation rates</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2005-07-01</date><risdate>2005</risdate><volume>190</volume><issue>1</issue><spage>18</spage><epage>22</epage><pages>18-22</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>This study evaluates differences in the utilization of breast conservation surgery (BCS) between major metropolitan areas in the United States (US) and the United Kingdom (UK).
Surgical and staging information were obtained from the Cancer Surveillance Program for Los Angeles County (LAC), the New York State (NYS) Department of Health Cancer Registry, and the UK National Health Service (NHS) Breast Screening Program. Demographic data were obtained from the census databases from the US, UK, Northern Ireland, and Scotland. Descriptive statistics, correlation analysis, and chi-square tests were used to compare rates of BCS across the locations under study.
Breast conservation rates were highest in London (79.3%) compared to New York City (NYC) (69.7%) and LAC (66.5%) (
P < .0001). Both in NYS and the UK, the cities differ from the surrounding regions in population density, education levels, agricultural activities, and unemployment. BCS rates tended to increase with population density and education levels, and decrease with increased unemployment and agricultural activity, but there was no impact on BCS rates when adjustments for these variables were included in regression models. BCS rates increase with increasing hospital case volume in LAC and NYC (
P < .0001).
When comparing large metropolitan areas in the US and UK there are significantly different rates of BCS in different locations. These differences reflect differences in population density, socioeconomic status (SES), education levels, hospital volume, and the effects of a nationally funded screening program.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15972165</pmid><doi>10.1016/j.amjsurg.2004.12.002</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Attitude of Health Personnel Biological and medical sciences Breast cancer Breast conservation Breast Neoplasms - mortality Breast Neoplasms - pathology Breast Neoplasms - surgery Cancer surgery Cancer therapies Censuses Confidence Intervals Demographics Economic conditions Education Female General aspects Health Care Surveys Humans Incidence Labor force Linear Models Mastectomy, Segmental - methods Mastectomy, Segmental - statistics & numerical data Medical sciences Neoplasm Invasiveness - pathology Neoplasm Staging Odds Ratio Patient Selection Population Density Practice Patterns, Physicians Probability Radiation therapy Registries Risk Assessment Socioeconomic factors Studies Surgery Survival Rate Teaching hospitals Therapy Treatment Outcome Unemployment United Kingdom United States |
| title | The importance of location in determining breast conservation rates |
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