A multilevel investigation of inequalities in clinical and psychosocial outcomes for women after breast cancer

Youl, Philippa H. and Baade, Peter D. and Aitken, Joanne F. and Chambers, Suzanne K. and Turrell, Gavin and Pyke, Christopher and Dunn, Jeffrey (2011) A multilevel investigation of inequalities in clinical and psychosocial outcomes for women after breast cancer. BMC Cancer, 11.

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Abstract

Background: In Australia, breast cancer is the most common cancer affecting Australian women. Inequalities in clinical and psychosocial outcomes have existed for some time, affecting particularly women from rural areas and from areas of disadvantage. We have a limited understanding of how individual and area-level factors are related to each other, and their associations with survival and other clinical and psychosocial outcomes.Methods/Design: This study will examine associations between breast cancer recurrence, survival and psychosocial outcomes (e.g. distress, unmet supportive care needs, quality of life). The study will use an innovative multilevel approach using area-level factors simultaneously with detailed individual-level factors to assess the relative importance of remoteness, socioeconomic and demographic factors, diagnostic and treatment pathways and processes, and supportive care utilization to clinical and psychosocial outcomes. The study will use telephone and self-administered questionnaires to collect individual-level data from approximately 3, 300 women ascertained from the Queensland Cancer Registry diagnosed with invasive breast cancer residing in 478 Statistical Local Areas Queensland in 2011 and 2012. Area-level data will be sourced from the Australian Bureau of Statistics census data. Geo-coding and spatial technology will be used to calculate road travel distances from patients' residence to diagnostic and treatment centres. Data analysis will include a combination of standard empirical procedures and multilevel modelling.Discussion: The study will address the critical question of: what are the individual- or area-level factors associated with inequalities in outcomes from breast cancer? The findings will provide health care providers and policy makers with targeted information to improve the management of women with breast cancer, and inform the development of strategies to improve psychosocial care for women with breast cancer.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Published version made available under Open Access.
Faculty / Department / School: No Faculty
Date Deposited: 09 Jun 2017 02:36
Last Modified: 09 Jun 2017 02:36
Uncontrolled Keywords: Cancer; Public Health, Social Medicine and Epidemiology;
Fields of Research : 11 Medical and Health Sciences > 1112 Oncology and Carcinogenesis > 111299 Oncology and Carcinogenesis not elsewhere classified
Socio-Economic Objective: E Expanding Knowledge > 97 Expanding Knowledge > 970111 Expanding Knowledge in the Medical and Health Sciences
Identification Number or DOI: 10.1186/1471-2407-11-415
URI: http://eprints.usq.edu.au/id/eprint/32052

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