Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Socioeconomic position and prognosis in premenopausal breast cancer: a population-based cohort study in Denmark

Research output: Contribution to journalJournal articleResearchpeer-review

  1. The effects of selected inhibitors on human fetal adrenal steroidogenesis differs under basal and ACTH-stimulated conditions

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Mendelian randomization-a powerful tool to study the causal effects of atrial fibrillation on loss of brain volume

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Breast cancer risk factors and their effects on survival: a Mendelian randomisation study

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Cerebral lactate uptake during exercise is driven by the increased arterial lactate concentration

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. DBCG Kvalitetsdatabase for Brystkræft – resumé af årsrapport 2020

    Research output: Contribution to journalJournal articleCommunication

  3. A careful reassessment of anthracycline use in curable breast cancer

    Research output: Contribution to journalReviewResearchpeer-review

View graph of relations

BACKGROUND: To investigate how socioeconomic position (SEP) influences the effectiveness of cancer-directed treatment in premenopausal breast cancer patients in terms of breast cancer recurrence and mortality.

METHODS: We conducted a cohort study nested in the ProBeCaRe (Predictors of Breast Cancer Recurrence) cohort (n = 5959). We identified all premenopausal women aged 18-55 years diagnosed with non-metastatic breast cancer and prescribed docetaxel-based chemotherapy in Denmark during 2007-2011. Population-based administrative registries provided data on SEP: marital status (married including registered partnership or single including divorced or widowed), cohabitation (cohabiting or living alone), education (low, intermediate, or high), income (low, medium, or high), and employment status (employed, unemployed, or health-related absenteeism). For each SEP measure, we computed incidence rates, cumulative incidence proportions (CIPs), and used Poisson regression to compute incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of recurrence and death. We stratified on estrogen receptor (ER) status/tamoxifen to evaluate interaction.

RESULTS: Our study cohort included 2616 women; 286 (CIP 13%) experienced recurrence and 223 (CIP 11%) died during follow-up (median 6.6 and 7.2 years, respectively). Single women had both increased 5-year risks of recurrence (IRR 1.45, 95% CI 1.11-1.89) and mortality (IRR 1.83, 95% CI 1.32-2.52). Furthermore, we observed increased 5-year mortality in women with low education (IRR 1.49, 95% CI 0.95-2.33), low income (IRR 1.37, 95% CI 0.83-2.28), unemployment (IRR 1.61, 95% CI 0.83-3.13), or health-related work absenteeism (IRR 1.80, 95% CI 1.14-2.82), but smaller or no increased risk of recurrence. These findings were especially evident among women with ER+ tumors prescribed tamoxifen. Overall analyses (follow-up max. 10 years) provided similar results.

CONCLUSIONS: Low SEP in premenopausal women with non-metastatic breast cancer was associated with increased mortality, but not always recurrence. This suggests underdetection of recurrences in certain groups. Poor prognosis in women with low SEP, especially single women, may partly be explained by tamoxifen adherence.

Original languageEnglish
Article number235
JournalBMC Medicine
Volume19
Issue number1
Pages (from-to)235
ISSN1741-7015
DOIs
Publication statusPublished - 30 Sep 2021

Bibliographical note

© 2021. The Author(s).

ID: 68605284