Diagnosis and treatment pattern among rural and urban breast cancer patients in Southwest China from 2005 to 2009

Abstract

The incidence of all cancers in China is generally higher in urban areas; however, the mortality risk for affected patients is considerably higher in rural areas. We present a subanalysis investigating the differences in patient and disease characteristics, treatment patterns, and outcomes between rural and urban patients who were diagnosed with breast cancer at West China Hospital between 2005-2009. Baseline patient and disease characteristics were recorded, and patients were followed up for a minimum of 3 years, or until death. For this subanalysis, patients were stratified by their residential status (rural or urban). Of the 2252 patients in the cohort, 76.3% were from urban areas and 22.1% were from rural areas. Significant differences were observed in the prevalence of luminal A and human epidermal growth factor receptor 2-positive breast cancers among rural and urban patients. Estrogen receptor (ER)-positive patients were less likely to receive anti-ER therapy if they were from rural areas compared with urban areas; the use of aromatase inhibitors was also significantly lower for rural patients than urban patients. Univariate, multivariate, and Kaplan-Meier analyses all demonstrated that overall survival and progression-free survival were significantly lower for rural patients than urban patients.