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Impact of a cancer screening program on breast cancer stage at diagnosis in a medically underserved urban community.
- Source :
-
Journal of the American College of Surgeons [J Am Coll Surg] 2003 Feb; Vol. 196 (2), pp. 180-8. - Publication Year :
- 2003
-
Abstract
- Background: Our previous report showed that the disparity in breast carcinoma survival between black and white women because of advanced stage of disease at presentation in poor black women is related to their low socioeconomic status and lack of health insurance. This observation led to establishment of a community-oriented free cancer screening service.<br />Study Design: To evaluate the impact of screening on breast cancer stage at diagnosis, analysis of data from the Harlem Hospital Tumor Registry between 1995 and 2000 was performed and compared with our 1964-1986 report.<br />Results: Twenty-three percent of cancers (324 of 1,405) diagnosed between 1995 and 2000 were breast carcinoma. Data confirm that lack of insurance remains a major problem among poor black women. We observed a marked fall, from 49% in our earlier report to 21% in this study, in late-stage (III and IV) disease at presentation. This fall is associated with significant (p < 0.001) improvement in early detection of breast cancer, with 41% of cancers in stages 0 and I in this data compared with 6% in the previous study. Of note, 53% of women with breast carcinoma had breast-conserving surgery and 45% had modified radical mastectomy in this study; 71% had radical or modified radical mastectomy in the earlier report.<br />Conclusions: This study confirms the importance of a free cancer screening program in the improvement of early-stage breast cancer detection, treatment, and survival in a poor urban community.
- Subjects :
- Adenocarcinoma economics
Adenocarcinoma epidemiology
Adenocarcinoma therapy
Adolescent
Adult
Aged
Aged, 80 and over
Breast Neoplasms economics
Breast Neoplasms epidemiology
Breast Neoplasms therapy
Female
Health Services Accessibility economics
Humans
Male
Medically Uninsured statistics & numerical data
Middle Aged
Neoplasm Staging
New York City epidemiology
Socioeconomic Factors
Survival Analysis
Urban Population
Adenocarcinoma diagnosis
Breast Neoplasms diagnosis
Mass Screening statistics & numerical data
Medically Underserved Area
Outpatient Clinics, Hospital statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1072-7515
- Volume :
- 196
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of the American College of Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 12595043
- Full Text :
- https://doi.org/10.1016/S1072-7515(02)01765-9