Skip to main content
. Author manuscript; available in PMC: 2010 Jul 22.
Published in final edited form as: Health Place. 2009 Sep 30;16(1):156–163. doi: 10.1016/j.healthplace.2009.09.011

Table 2.

Associations of country and place with breast cancer care and survival: relatively poor compared with affluent neighborhoods, and extremely poor compared with extremely affluent neighborhoods.

Cancer care indicator California
 Ontario
 Ontario/California
Neighborhood n Ratea RRb 95% CIc n Ratea RRb 95% CIc RR 95% CIc
Localized disease at diagnosis
 Extremely affluent 50 0.720 1.00 … 50 0.680 1.00 … 0.94 0.71, 1.24
 Affluent 99 0.677 1.00 … 100 0.641 1.00 … 0.95 0.80, 1.13
 Poor 100 0.600 0.89 0.73, 1.09 100 0.648 1.01 0.89, 1.15 1.08 0.88, 1.33
 Extremely poor 50 0.512 0.71 0.52, 0.97 50 0.640 0.94 0.71, 1.25 1.25 0.90, 1.74
Received lumpectomy
 Extremely affluent 50 0.644 1.00 … 50 0.646 1.00 … 1.00 0.94, 1.06
 Affluent 99 0.596 1.00 … 100 0.630 1.00 … 1.06 0.84, 1.34
 Poor 99 0.545 0.91 0.70, 1.18 99 0.708 1.12 0.92, 1.36 1.30 1.05, 1.62
 Extremely poor 50 0.477 0.74 0.55, 0.99d 49 0.718 1.11 0.85, 1.45 1.51 1.09, 2.09
Received radiation therapy
 Extremely affluent 50 0.620 1.00 … 50 0.564 1.00 … 0.91 0.67, 1.23
 Affluent 99 0.566 1.00 … 100 0.520 1.00 … 0.92 0.72, 1.18
 Poor 100 0.480 0.85 0.65, 1.10 100 0.572 1.10 0.85, 1.43 1.19 0.91, 1.56
 Extremely poor 50 0.286 0.46 0.29, 0.73 50 0.631 1.12 0.85, 1.47 2.21 1.42, 3.45
Received chemotherapy
 Extremely affluent 49 0.426 1.00 … 50 0.406 1.00 … 0.95 0.67, 1.34
 Affluent 98 0.425 1.00 … 100 0.371 1.00 … 0.87 0.64, 1.19
 Poor 99 0.414 0.97 0.72, 1.30 100 0.386 1.04 0.80, 1.35 0.93 0.70, 1.24
 Extremely poor 50 0.411 0.96 0.60, 1.52 49 0.423 1.04 0.56, 1.95 1.03 0.74, 1.44
Received hormonal therapy
 Extremely affluent 48 0.520 1.00 … 50 0.498 1.00 … 0.96 0.64, 1.43
 Affluent 98 0.455 1.00 … 100 0.541 1.00 … 1.19 0.91, 1.55
 Poor 98 0.287 0.63 0.43, 0.92 100 0.547 1.01 0.88, 1.16 1.91 1.36, 2.67
 Extremely poor 49 0.312 0.60 0.36, 0.99 49 0.551 1.11 0.75, 1.65 1.77 1.12, 2.79
Five-year survival
 Extremely affluent 50 0.812 1.00 … 50 0.883 1.00 … 1.09 0.89, 1.33
 Affluent 99 0.806 1.00 … 100 0.887 1.00 … 1.10 0.98, 1.23
 Poor 100 0.690 0.86 0.74, 1.00 100 0.828 0.94 0.85, 1.04 1.20 1.03, 1.40
 Extremely poor 50 0.663 0.82 0.68, 0.99d 50 0.803 0.91 0.77, 1.08 1.21 1.01, 1.45d

Notes: Within-country comparisons were of the poor versus the affluent and of the extremely poor versus the extremely affluent. n=number of incident breast cancer cases, RR=standardized rate ratio, CI=confidence interval. Bolded RRs and CIs are statistically significant.

a

All rates were directly age-adjusted using this study’s combined Ontario-California population of cases as the standard (age strata: 25–44, 45–54, 55–64, 65–74 and 75 years or older), so all of the rates for each cancer care indicator are directly comparable.

b

A survival rate ratio of 1.00 is the within-country baseline.

c

Confidence intervals are based on the Mantel–Haenszel χ2-test.

d

90% confidence interval.