The impact of sociodemographic factors and health insurance coverage in the diagnosis and clinicopathological characteri
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EPIDEMIOLOGY
The impact of sociodemographic factors and health insurance coverage in the diagnosis and clinicopathological characteristics of breast cancer in Brazil: AMAZONA III study (GBECAM 0115) Daniela Dornelles Rosa1 · José Bines2 · Gustavo Werutsky3 · Carlos Henrique Barrios3 · Eduardo Cronemberger4 · Geraldo Silva Queiroz5 · Vladmir C. Cordeiro de Lima6 · Ruffo Freitas‑Júnior7 · José d’Oliveira Couto8 · Karla Emerenciano9 · Heloísa Resende10 · Susane Crocamo11 · Tomás Reinert12 · Brigitte Van Eyil13 · Yeni Nerón14 · Vanessa Dybal15 · Nicolas Lazaretti16 · Rita de Cassia Costamilan17 · Diocésio Alves Pinto de Andrade18 · Clarissa Mathias19 · Giovana Zerwes Vacaro16 · Giuliano Borges20 · Alessandra Morelle1 · Maira Caleffi1 · Carlos Sampaio Filho15 · Max S. Mano21 · Facundo Zaffaroni3 · Rafaela Gomes de Jesus3 · Sergio Daniel Simon22 Received: 29 February 2020 / Accepted: 21 July 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose In Brazil, the available cancer registries are deficient in number and quality and, hence, little information is known regarding sociodemographic, clinicopathological characteristics, treatment patterns, and outcomes of breast cancer (BC) patients. We performed the AMAZONA III/ GBECAM 0115 study and in this analysis, we describe patients’ characteristics at diagnosis and their association with health insurance type. Methods This is a prospective cohort study developed in 23 sites in Brazil including women with newly diagnosed invasive BC from January 2016 to March 2018. In order to compare healthcare insurance type, we considered patients who were treated under the Brazilian public health system as publicly insured, and women who had private insurance or paid for their treatment as privately insured. Results A total of 2950 patients were included in the study. Median age at diagnosis was 53.9 years; 63.1% were publicly insured. The majority of patients (68.6%) had stage II–III breast cancer and ductal carcinoma histology (80.9%). The most common breast cancer subtype was luminal A-like (48.0%) followed by luminal B-HER2 positive-like (17.0%) and triplenegative (15.6%). Luminal A was more frequent in private (53.7% vs. 44.2%, p
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