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Impact of a positive family history on diagnosis, management, and survival of breast cancer: different effects across socio-economic groups

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Abstract

Background

This study aims to investigate whether increased awareness of breast cancer, due to a positive family history (FH), reduces diagnostic, therapeutic, and survival differences between women of low versus high socio-economic status (SES).

Methods

All breast cancer patients registered between 1990 and 2005 at the population-based Geneva Cancer Registry were included. With multivariate logistic and Cox regression analysis, we estimated the impact of SES and FH on method of detection, treatment, and mortality from breast cancer.

Results

SES discrepancies in method of detection and suboptimal treatment, as seen among women without a FH, disappeared in the presence of a positive FH. SES differences in stage and survival remained regardless of the presence of a positive FH. Overall, positive FH was associated with better survival. This effect was the strongest in women of high SES (age-adjusted Hazard Ratio [HRageadj] 0.54 [0.3–1.0]) but less pronounced in women of middle (0.77 [0.6–1.0]), and absent in women of low SES (0.80 [0.5–1.2]).

Conclusion

A positive FH of breast cancer may reduce SES differences in access to screening and optimal treatment. However, even with better access to early detection and optimal treatment, women of low SES have higher risks of death from their disease than those of high SES.

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Acknowledgments

The authors wish to thank Mrs. Stina Blagojevich for editorial support. This work was financially supported by the Swiss Cancer League (Grant number OCS-02070-04-2007).

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Authors and Affiliations

  1. Geneva Cancer Registry, Geneva University, Geneva, Switzerland

    H. M. Verkooijen, E. Rapiti, G. Fioretta, J. Keller & C. Bouchardy

  2. Department of Epidemiology and Public Health, National University of Singapore, Singapore, Singapore

    H. M. Verkooijen

  3. Oncology Center, University Hospital Brussels, Brussels, Belgium

    V. Vinh-Hung

  4. INSERM, U946, Fondation Jean Dausset, CEPH, Paris, France

    S. Benhamou

  5. CNRS FRE2939, Gustave-Roussy Institute, Villejuif, France

    S. Benhamou

  6. Senology and Surgical Gynecologic Oncology Unit, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland

    G. Vlastos

  7. Division of Genetic Medicine, Geneva University Hospitals, Geneva, Switzerland

    P. O. Chappuis

  8. 55 Boulevard de la Cluse, 1205, Geneva, Switzerland

    C. Bouchardy

Authors
  1. H. M. Verkooijen
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  2. E. Rapiti
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  3. G. Fioretta
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  4. V. Vinh-Hung
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  5. J. Keller
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  6. S. Benhamou
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  7. G. Vlastos
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  8. P. O. Chappuis
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  9. C. Bouchardy
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Corresponding author

Correspondence to C. Bouchardy.

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Verkooijen, H.M., Rapiti, E., Fioretta, G. et al. Impact of a positive family history on diagnosis, management, and survival of breast cancer: different effects across socio-economic groups. Cancer Causes Control 20, 1689–1696 (2009). https://doi.org/10.1007/s10552-009-9420-1

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  • DOI: https://doi.org/10.1007/s10552-009-9420-1

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