Table 1.
Characteristics of women with ductal carcinoma in situ by socioeconomic deprivation and urban/rural locations at the time of diagnosis in the Missouri Cancer Registry, 1996–2011
| Socioeconomic deprivation | Urban/rural location | |||||
|---|---|---|---|---|---|---|
| Lowest tertile N (%) |
Highest tertile N (%) |
P | Urban N (%) |
Rural N (%) |
P | |
| Number of cases | 4306 | 1997 | 7074 | 2121 | ||
| Age at diagnosis, y | ||||||
| Mean (SD) | 59.5 (12.5) | 62.3 (12.9) | <.0001 | 60.1 (12.6) | 61.7 (12.4) | <.0001 |
| <50 | 1021 (23.7) | 360 (18.0) | 1595 (22.6) | 372 (17.5) | ||
| 50–59 | 1234 (28.7) | 481 (24.1) | 1918 (27.1) | 563 (26.5) | ||
| 60–69 | 1070 (24.9) | 541 (27.1) | 1809 (25.6) | 570 (26.9) | ||
| ≥70 | 981 (22.8) | 615 (30.8) | <.0001 | 1752 (24.8) | 616 (29.0) | <.0001 |
| Race and ethnicity | ||||||
| Non-Hispanic white | 3989 (92.6) | 1458 (73.0) | 6013 (85.0) | 2052 (96.8) | ||
| Non-Hispanic black | 194 (4.5) | 503 (25.2) | 877 (12.4) | 38 (1.8) | ||
| Others | 123 (2.9) | 36 (1.8) | <.0001 | 184 (2.6) | 31 (1.5) | <.0001 |
| Length of follow-up, months | ||||||
| Median (range) | 77 (2, 191) | 71 (2, 191) | 0.0006 | 74 (2, 191) | 78 (2, 191) | 0.001 |
| 6–11 | 294 (6.8) | 123 (6.2) | 536 (7.6) | 88 (4.2) | ||
| 12–59 | 1362 (31.6) | 721 (36.1) | 2340 (33.1) | 709 (33.4) | ||
| 60–119 | 1473 (34.2) | 688 (34.5) | 2415 (34.1) | 768 (36.2) | ||
| ≥120 | 1177 (27.3) | 465 (23.3) | 0.001 | 1783 (25.2) | 556 (26.2) | <.0001 |
| Year of the first DCIS diagnosis | ||||||
| 1996–1999 | 932 (21.6) | 392 (19.6) | 1481 (20.9) | 418 (19.7) | ||
| 2000–2004 | 1411 (32.8) | 656 (32.9) | 2232 (31.6) | 755 (35.6) | ||
| 2005–2009 | 1446 (33.6) | 722 (36.2) | 2409 (34.1) | 796 (37.5) | ||
| 2010–2011 | 517 (12.0) | 227 (11.4) | 0.15 | 952 (13.5) | 152 (7.2) | <.0001 |
| Health insurance | ||||||
| Private | 966 (66.9) | 299 (44.3) | 1532 (61.4) | 301 (47.9) | ||
| Medicare | 445 (30.8) | 295 (43.7) | 842 (33.7) | 285 (45.3) | ||
| Medicaid or uninsured | 34 (2.4) | 81 (12.0) | <.0001 | 122 (4.9) | 43 (6.8) | <.0001 |
| Other or missing | 2861 | 1322 | 4578 | 1492 | ||
| Histological subtype | ||||||
| Not otherwise specified | 3101 (72.0) | 1397 (70.0) | 5062 (71.6) | 1484 (70.0) | ||
| Comedo | 499 (11.6) | 274 (13.7) | 824 (11.7) | 315 (14.9) | ||
| Papillary | 291 (6.8) | 174 (8.7) | 518 (7.3) | 167 (7.9) | ||
| Cribiform | 243 (5.6) | 82 (4.1) | 394 (5.6) | 87 (4.1) | ||
| Solid | 172 (4.0) | 70 (3.5) | 0.01 | 276 (3.9) | 68 (3.2) | <.0001 |
| Grade | ||||||
| Well differentiated | 628 (20.8) | 291 (22.6) | 1063 (21.4) | 273 (21.5) | ||
| Moderately differentiated | 1078 (35.7) | 452 (35.1) | 1800 (36.3) | 472 (37.1) | ||
| Poorly differentiated | 1314 (43.5) | 546 (42.4) | 0.05 | 2094 (42.2) | 526 (41.4) | 0.83 |
| Missing | 1286 | 708 | 2117 | 850 | ||
| Tumor size, cm | ||||||
| <2.0 | 927 (72.9) | 467 (70.3) | 1604 (71.6) | 487 (70.8) | ||
| ≥2.0 | 345 (27.1) | 197 (29.7) | 0.32 | 635 (28.4) | 201 (29.2) | 0.66 |
| Missing | 3034 | 1333 | 4835 | 1433 | ||
| Estrogen receptor | ||||||
| Negative | 304 (16.1) | 160 (18.9) | 538 (16.9) | 175 (20.3) | ||
| Positive | 1590 (84.0) | 686 (81.1) | 0.05 | 2648 (83.1) | 687 (79.7) | 0.02 |
| Missing | 2412 | 1151 | 3888 | 1259 | ||
| Surgery for first DCIS | ||||||
| None | 89 (2.1) | 64 (3.2) | 166 (2.4) | 55 (2.6) | ||
| BCS | 2965 (69.1) | 1191 (60.0) | 4717 (67.0) | 1307 (62.1) | ||
| Mastectomy | 1237 (28.8) | 729 (36.7) | <.0001 | 2156 (30.6) | 744 (35.3) | 0.0001 |
| Missing | 15 | 13 | 35 | 15 | ||
| Surgical margin† | ||||||
| Clear | 3874 (96.0) | 1730 (95.8) | 6337 (96.0) | 1794 (95.6) | ||
| Positive | 162 (4.0) | 75 (4.2) | 0.97 | 261 (4.0) | 82 (4.4) | 0.42 |
| Missing | 166 | 115 | 275 | 175 | ||
| Radiation therapy for first DCIS | ||||||
| No | 1980 (46.2) | 1207 (61.3) | 3489 (49.6) | 1274 (61.3) | ||
| Yes | 2303 (53.8) | 763 (38.7) | <.0001 | 3545 (50.4) | 803 (38.7) | <.0001 |
| Missing | 23 | 27 | 40 | 44 | ||
| Surgery and radiation therapy for first DCIS | ||||||
| No surgical treatment | 89 (2.1) | 64 (3.2) | 166 (2.4) | 55 (2.6) | ||
| BCS alone | 683 (16.0) | 442 (22.4) | 1220 (17.4) | 508 (24.4) | ||
| BCS and radiation | 2271 (53.1) | 738 (37.4) | 3479 (49.6) | 776 (37.3) | ||
| Mastectomy | 1237 (28.9) | 729 (37.0) | <.0001 | 2156 (30.7) | 744 (35.7) | <.0001 |
| Missing | 26 | 24 | 53 | 38 | ||
| Weeks from surgery to radiation, mean (SD)‡ | 6.2 (3.8) | 7.2 (4.7) | <.0001 | 6.5 (4.2) | 6.4 (3.8) | 0.53 |
| Guideline concordant use of endocrine therapy§ | ||||||
| No | 1171 (59.6) | 655 (67.1) | 2018 (61.1) | 689 (67.8) | ||
| Yes | 794 (40.4) | 321 (32.9) | 0.0002 | 1287 (38.9) | 328 (32.3) | 0.0001 |
| Missing | 113 | 48 | 214 | 37 | ||
†
The comparison was made in the patients with surgical treatment.
‡
The analysis was limited to the patients who received radiation therapy following definitive breast-conserving surgery.
§
The analysis included the patients with estrogen receptor-positive DCIS and the patients with breast-conserving surgery alone.