Abstract：
BACKGROUND:Breast-conserving surgery (BCS) followed by radiotherapy is generally the preferred treatment for women diagnosed with early stage breast cancer. This study aimed to investigate the proportion of patients who receive BCS versus mastectomy and post-BCS radiotherapy, and explore factors associated with receipt of these treatments in Alberta, Canada. METHODS:A retrospective population-based study was conducted that including all patients surgically treated with stage I-III breast cancer diagnosed in Alberta from 2002-2010. Clinical characteristics, treatment information and patient age at diagnosis were collected from the Alberta Cancer Registry. Log binomial multiple regression was used to calculate stage-specific relative risk estimates of receiving BCS and post-BCS radiotherapy. RESULTS:Of the 14 646 patients included in the study, 44% received BCS, and of those, 88% received post-BCS radiotherapy. The adjusted relative risk of BCS was highest in Calgary and lowest in Central Alberta for all disease stages. Relative to surgeries performed in Calgary, those performed in Central Alberta were significantly less likely to be BCS for stage I (RR = 0.65; 95% 0.57, 0.72), II (RR = 0.58; 95% 0.49, 0.68), and III (RR = 0.62; 95% CI: 0.37, 0.95) disease, respectively, adjusting for patient age at diagnosis, clinical and treatment characteristics. No significant variation of post-BCS radiotherapy was found. CONCLUSIONS:Factors such as region of surgical treatment should not be related to the receipt of standard care within a publicly-funded health care system. Further investigation is needed to understand the significant geographic variation present within the province in order to identify appropriate interventions.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Fisher S,Gao H,Yasui Y,Dabbs K,Winget Mdoi
10.1186/s12913-015-0680-zsubject
Has Abstractpub_date
2015-01-22 00:00:00pages
35issn
1472-6963pii
s12913-015-0680-zjournal_volume
15pub_type
杂志文章abstract：BACKGROUND:HIV treatment models in Africa are labour intensive and require a high number of skilled staff. In this context, task-shifting is considered a feasible alternative for ART service delivery. In 2006, a lay health cadre of expert patients (EPs) at a tertiary referral HIV clinic in Zomba, Malawi was capacitated...
journal_title：BMC health services research
pub_type： 杂志文章
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更新日期：2017-05-09 00:00:00
abstract：BACKGROUND:Health systems are expected to serve the population needs in an effective, efficient and equitable manner. Therefore, the importance of strengthening of public, private and community health systems has been emphasized time and again. In most of the developing countries, certain weaknesses and gaps in the gov...
journal_title：BMC health services research
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abstract：BACKGROUND:Treat-to-target is the recommended strategy for the management of rheumatoid arthritis (RA) and involves regular assessment of disease activity using validated measures and subsequent adjustment of medical therapy if patients are not in remission or low disease activity. Recommendations published in 2012 det...
journal_title：BMC health services research
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journal_title：BMC health services research
pub_type： 杂志文章,多中心研究,随机对照试验
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更新日期：2016-04-23 00:00:00
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pub_type： 杂志文章,多中心研究
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更新日期：2019-05-30 00:00:00
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更新日期：2019-03-14 00:00:00
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