Inter- and intra-provincial variation in screen-detected breast cancer across five Canadian provinces: a CanIMPACT study

for the Canadian Team to Improve Community-Based Cancer Care Along the Continuum (CanIMPACT)

doi:10.17269/s41997-019-00282-5

Inter- and intra-provincial variation in screen-detected breast cancer across five Canadian provinces: a CanIMPACT study

for the Canadian Team to Improve Community-Based Cancer Care Along the Continuum (CanIMPACT)

Medicine

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

3 Citas (Scopus)

Resumen

Objective: Breast cancer screening aims to identify cancers in early stages when prognosis is better and treatments less invasive. We describe inter- and intra-provincial variation in the percentage of screen-detected cases under publicly funded healthcare systems and factors related to having screen- vs non-screen-detected breast cancer across five Canadian provinces. Methods: Women aged 40+ diagnosed with incident breast cancer from 2007 to 2012 in five Canadian provinces were identified from their respective provincial cancer registries. Standardized provincial datasets were created linking screening, health administrative, and claims data. Province-specific logistic regression models were used to evaluate the association of demographic and healthcare utilization factors in each province with the odds of screen-detected cancer. Results: There was significant inter- and intra-provincial variation by age. Screen detection ranged from 42% to 52% in ages 50–69 but women aged 50–59 had approximately 4–8% lower screen detection than those aged 60–69 in all provinces. Screening associations with income quintile and rurality varied across provinces. Those least likely to be screen-detected within a province were consistently in the lowest income quintile; OR ranged from 0.62–0.89 relative to highest income quintile/urban patients aged 50–69. Lack of visits to primary care 30 months prior to diagnosis was also consistently associated with lower odds of screen detection (OR range, 0.37–0.76). Conclusion: Breast cancer screen detection rates in the Canadian provinces examined are relatively high. Associations with income-rurality indicate a need for greater attention and/or targeted outreach to specific communities and/or provincial regions to improve access to breast cancer screening services intra-provincially.

Idioma original	English
Páginas (desde-hasta)	794-803
Número de páginas	10
Publicación	Canadian Journal of Public Health
Volumen	111
N.º	5
DOI	https://doi.org/10.17269/s41997-019-00282-5
Estado	Published - oct. 1 2020

Nota bibliográfica

Funding Information:
This work was supported by the Canadian Institutes of Health Research [grant number128272]. The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funder. This study is supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. Parts of this material are based on data and information provided by Cancer Care Ontario (CCO). The opinions, results, views, and conclusions reported in this paper are those of the authors and do not necessarily reflect those of CCO. No endorsement by CCO is intended or should be inferred. Parts of this material are based on data and information compiled and provided by the Canadian Institute for Health Information (CIHI). However, the analyses, conclusions, opinions and statements expressed herein are those of the authors, and not necessarily those of CIHI. We gratefully acknowledge CancerCare Manitoba for their ongoing support and Manitoba Health for the provision of data. The results and conclusions presented are those of the authors. No official endorsement by Manitoba Health is intended or should be inferred. Nova Scotia data were provided by Health Data Nova Scotia and the Nova Scotia Department of Health and Wellness, however, the observations and opinions expressed are those of the authors and do not represent those of either Health Data Nova Scotia or the Department of Health and Wellness. Data for this study were also provided by Population Data BC and BC Cancer. All inferences, opinions, and conclusions drawn in this study are those of the authors, and do not reflect the opinions or policies of the BC Data Steward(s).(“BC Cancer Agency Registry Data. V2, Population Data BC: BC Cancer Agency; [Available from: http://www.popdata.bc.ca/Data .],” n.d.; “Medical Services Plan (MSP) Payment Information File. V2, MOH (): British Columbia Ministry of Health; 2011 [Available from: http://www.popdata.bc.ca/Data .],” n.d.; “Consolidation File (MSP Registration & Premium Billing). V2, Population Data BC: British Columbia Ministry of Health (); 2011 [Available from: http://www.popdata.bc.ca/Data .],” n.d.) Acknowledgements

Publisher Copyright:
© 2020, The Canadian Public Health Association.

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Public Health, Environmental and Occupational Health

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10.17269/s41997-019-00282-5

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Inter- and intra-provincial variation in screen-detected breast cancer across five Canadian provinces: a CanIMPACT study. / for the Canadian Team to Improve Community-Based Cancer Care Along the Continuum (CanIMPACT).
En: Canadian Journal of Public Health, Vol. 111, N.º 5, 01.10.2020, p. 794-803.

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

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title = "Inter- and intra-provincial variation in screen-detected breast cancer across five Canadian provinces: a CanIMPACT study",

abstract = "Objective: Breast cancer screening aims to identify cancers in early stages when prognosis is better and treatments less invasive. We describe inter- and intra-provincial variation in the percentage of screen-detected cases under publicly funded healthcare systems and factors related to having screen- vs non-screen-detected breast cancer across five Canadian provinces. Methods: Women aged 40+ diagnosed with incident breast cancer from 2007 to 2012 in five Canadian provinces were identified from their respective provincial cancer registries. Standardized provincial datasets were created linking screening, health administrative, and claims data. Province-specific logistic regression models were used to evaluate the association of demographic and healthcare utilization factors in each province with the odds of screen-detected cancer. Results: There was significant inter- and intra-provincial variation by age. Screen detection ranged from 42% to 52% in ages 50–69 but women aged 50–59 had approximately 4–8% lower screen detection than those aged 60–69 in all provinces. Screening associations with income quintile and rurality varied across provinces. Those least likely to be screen-detected within a province were consistently in the lowest income quintile; OR ranged from 0.62–0.89 relative to highest income quintile/urban patients aged 50–69. Lack of visits to primary care 30 months prior to diagnosis was also consistently associated with lower odds of screen detection (OR range, 0.37–0.76). Conclusion: Breast cancer screen detection rates in the Canadian provinces examined are relatively high. Associations with income-rurality indicate a need for greater attention and/or targeted outreach to specific communities and/or provincial regions to improve access to breast cancer screening services intra-provincially.",

author = "{for the Canadian Team to Improve Community-Based Cancer Care Along the Continuum (CanIMPACT)} and Marcy Winget and Yan Yuan and McBride, {Mary L.} and Cynthia Kendell and Decker, {Kathleen M.} and Eva Grunfeld and Groome, {Patti A.} and Natalie Biswanger and Dongdong Li and Aisha Lofters and Sharon Matthias and Nicole Mittmann and Rahim Moineddin and Geoff Porter and Dawn Powell and Donna Turner and Robin Urquhart and Bonnie Vick",

note = "Funding Information: This work was supported by the Canadian Institutes of Health Research [grant number128272]. The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funder. This study is supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. Parts of this material are based on data and information provided by Cancer Care Ontario (CCO). The opinions, results, views, and conclusions reported in this paper are those of the authors and do not necessarily reflect those of CCO. No endorsement by CCO is intended or should be inferred. Parts of this material are based on data and information compiled and provided by the Canadian Institute for Health Information (CIHI). However, the analyses, conclusions, opinions and statements expressed herein are those of the authors, and not necessarily those of CIHI. We gratefully acknowledge CancerCare Manitoba for their ongoing support and Manitoba Health for the provision of data. The results and conclusions presented are those of the authors. No official endorsement by Manitoba Health is intended or should be inferred. Nova Scotia data were provided by Health Data Nova Scotia and the Nova Scotia Department of Health and Wellness, however, the observations and opinions expressed are those of the authors and do not represent those of either Health Data Nova Scotia or the Department of Health and Wellness. Data for this study were also provided by Population Data BC and BC Cancer. All inferences, opinions, and conclusions drawn in this study are those of the authors, and do not reflect the opinions or policies of the BC Data Steward(s).(“BC Cancer Agency Registry Data. V2, Population Data BC: BC Cancer Agency; [Available from: http://www.popdata.bc.ca/Data .],” n.d.; “Medical Services Plan (MSP) Payment Information File. V2, MOH (): British Columbia Ministry of Health; 2011 [Available from: http://www.popdata.bc.ca/Data .],” n.d.; “Consolidation File (MSP Registration & Premium Billing). V2, Population Data BC: British Columbia Ministry of Health (); 2011 [Available from: http://www.popdata.bc.ca/Data .],” n.d.) Acknowledgements Publisher Copyright: {\textcopyright} 2020, The Canadian Public Health Association.",

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doi = "10.17269/s41997-019-00282-5",

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T1 - Inter- and intra-provincial variation in screen-detected breast cancer across five Canadian provinces

T2 - a CanIMPACT study

AU - for the Canadian Team to Improve Community-Based Cancer Care Along the Continuum (CanIMPACT)

AU - Winget, Marcy

AU - Yuan, Yan

AU - McBride, Mary L.

AU - Kendell, Cynthia

AU - Decker, Kathleen M.

AU - Grunfeld, Eva

AU - Groome, Patti A.

AU - Biswanger, Natalie

AU - Li, Dongdong

AU - Lofters, Aisha

AU - Matthias, Sharon

AU - Mittmann, Nicole

AU - Moineddin, Rahim

AU - Porter, Geoff

AU - Powell, Dawn

AU - Turner, Donna

AU - Urquhart, Robin

AU - Vick, Bonnie

N1 - Funding Information: This work was supported by the Canadian Institutes of Health Research [grant number128272]. The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funder. This study is supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. Parts of this material are based on data and information provided by Cancer Care Ontario (CCO). The opinions, results, views, and conclusions reported in this paper are those of the authors and do not necessarily reflect those of CCO. No endorsement by CCO is intended or should be inferred. Parts of this material are based on data and information compiled and provided by the Canadian Institute for Health Information (CIHI). However, the analyses, conclusions, opinions and statements expressed herein are those of the authors, and not necessarily those of CIHI. We gratefully acknowledge CancerCare Manitoba for their ongoing support and Manitoba Health for the provision of data. The results and conclusions presented are those of the authors. No official endorsement by Manitoba Health is intended or should be inferred. Nova Scotia data were provided by Health Data Nova Scotia and the Nova Scotia Department of Health and Wellness, however, the observations and opinions expressed are those of the authors and do not represent those of either Health Data Nova Scotia or the Department of Health and Wellness. Data for this study were also provided by Population Data BC and BC Cancer. All inferences, opinions, and conclusions drawn in this study are those of the authors, and do not reflect the opinions or policies of the BC Data Steward(s).(“BC Cancer Agency Registry Data. V2, Population Data BC: BC Cancer Agency; [Available from: http://www.popdata.bc.ca/Data .],” n.d.; “Medical Services Plan (MSP) Payment Information File. V2, MOH (): British Columbia Ministry of Health; 2011 [Available from: http://www.popdata.bc.ca/Data .],” n.d.; “Consolidation File (MSP Registration & Premium Billing). V2, Population Data BC: British Columbia Ministry of Health (); 2011 [Available from: http://www.popdata.bc.ca/Data .],” n.d.) Acknowledgements Publisher Copyright: © 2020, The Canadian Public Health Association.

PY - 2020/10/1

Y1 - 2020/10/1

N2 - Objective: Breast cancer screening aims to identify cancers in early stages when prognosis is better and treatments less invasive. We describe inter- and intra-provincial variation in the percentage of screen-detected cases under publicly funded healthcare systems and factors related to having screen- vs non-screen-detected breast cancer across five Canadian provinces. Methods: Women aged 40+ diagnosed with incident breast cancer from 2007 to 2012 in five Canadian provinces were identified from their respective provincial cancer registries. Standardized provincial datasets were created linking screening, health administrative, and claims data. Province-specific logistic regression models were used to evaluate the association of demographic and healthcare utilization factors in each province with the odds of screen-detected cancer. Results: There was significant inter- and intra-provincial variation by age. Screen detection ranged from 42% to 52% in ages 50–69 but women aged 50–59 had approximately 4–8% lower screen detection than those aged 60–69 in all provinces. Screening associations with income quintile and rurality varied across provinces. Those least likely to be screen-detected within a province were consistently in the lowest income quintile; OR ranged from 0.62–0.89 relative to highest income quintile/urban patients aged 50–69. Lack of visits to primary care 30 months prior to diagnosis was also consistently associated with lower odds of screen detection (OR range, 0.37–0.76). Conclusion: Breast cancer screen detection rates in the Canadian provinces examined are relatively high. Associations with income-rurality indicate a need for greater attention and/or targeted outreach to specific communities and/or provincial regions to improve access to breast cancer screening services intra-provincially.

AB - Objective: Breast cancer screening aims to identify cancers in early stages when prognosis is better and treatments less invasive. We describe inter- and intra-provincial variation in the percentage of screen-detected cases under publicly funded healthcare systems and factors related to having screen- vs non-screen-detected breast cancer across five Canadian provinces. Methods: Women aged 40+ diagnosed with incident breast cancer from 2007 to 2012 in five Canadian provinces were identified from their respective provincial cancer registries. Standardized provincial datasets were created linking screening, health administrative, and claims data. Province-specific logistic regression models were used to evaluate the association of demographic and healthcare utilization factors in each province with the odds of screen-detected cancer. Results: There was significant inter- and intra-provincial variation by age. Screen detection ranged from 42% to 52% in ages 50–69 but women aged 50–59 had approximately 4–8% lower screen detection than those aged 60–69 in all provinces. Screening associations with income quintile and rurality varied across provinces. Those least likely to be screen-detected within a province were consistently in the lowest income quintile; OR ranged from 0.62–0.89 relative to highest income quintile/urban patients aged 50–69. Lack of visits to primary care 30 months prior to diagnosis was also consistently associated with lower odds of screen detection (OR range, 0.37–0.76). Conclusion: Breast cancer screen detection rates in the Canadian provinces examined are relatively high. Associations with income-rurality indicate a need for greater attention and/or targeted outreach to specific communities and/or provincial regions to improve access to breast cancer screening services intra-provincially.

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Inter- and intra-provincial variation in screen-detected breast cancer across five Canadian provinces: a CanIMPACT study

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