scholarly journals Public health insurance and cancer‐specific mortality risk among patients with breast cancer: A prospective cohort study in China

2020 ◽  
Vol 148 (1) ◽  
pp. 28-37
Author(s):  
Yuxin Xie ◽  
Unnur A. Valdimarsdóttir ◽  
Chengshi Wang ◽  
XiaoRong Zhong ◽  
Qiheng Gou ◽  
...  
Keyword(s):  
Public Health ◽  
Breast Cancer ◽  
Cohort Study ◽  
Health Insurance ◽  
Prospective Cohort Study ◽  
Mortality Risk ◽  
Prospective Cohort ◽  
Public Health Insurance ◽  
Specific Mortality ◽  
Cancer Specific Mortality

scholarly journals Public health insurance and cancer-specific mortality risk among patients with breast cancer: a prospective cohort study in China

2020 ◽  
Author(s):  
yuxin Xie ◽  
Unnur A. Valdimarsdóttir ◽  
Chengshi Wang ◽  
XiaoRong Zhong ◽  
Qiheng Gou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Insurance ◽  
Mortality Risk ◽  
Cancer Prognosis ◽  
Total Charge ◽  
Reimbursement Rate ◽  
Insurance Scheme ◽  
Breast Cancer Specific Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality

Abstract Background Little is known about how health insurance policies, particularly in developing countries, may influence breast cancer prognosis. We aimed to examine the association between individual health insurance plans and breast cancer-specific mortality among patients in China.Methods We included 7,436 women diagnosed with invasive breast cancer between January 1 st , 2009, and December 31 st , 2016, at West China Hospital, Sichuan University. The health insurance plan of each patient was classified as either urban or rural schemes and was also categorized as reimbursement rate (i.e., the covered/ total charge) below or above the median. Breast cancer-specific mortality was the primary outcome. Using Cox proportional hazards models, we calculated hazard ratios (HRs) for cancer-specific mortality, contrasting rates among patients with a rural insurance scheme or low reimbursement rate to that of those with an urban insurance scheme or high reimbursement rate, respectively.Results During the median follow-up of 3.1 years, we identified 326 deaths due to breast cancer. Compared with patients covered by urban insurance schemes, patients covered by rural insurance schemes had a 29% increased cancer-specific mortality (95% CI 0% to 65%, P=0.046) after adjusting for demographics, tumor characteristics, and treatment modes. Reimbursement rate below the median was associated with a 42% increased rate of cancer-specific mortality (95% CI 11% to 82%). Every 10% increase in the reimbursement rate is associated with a 7% (95% CI, 2% to 12%) reduction in cancer-specific mortality risk, particularly in patients covered by rural insurance schemes (26%, 95% CI 9% to 39%).Conclusions Our findings suggest that under-insured patients with breast cancer in China face increased breast cancer-specific mortality, which may provide fresh insights into the role of reimbursement rate in cancer health disparities.

Cynical distrust increases breast cancer risk: Evidence from a prospective cohort study

2002 ◽  
Author(s):  
A. R. Aro ◽  
H. J. de Koning ◽  
K. Vehkalahti ◽  
P. Absetz ◽  
M. Schreck ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Prospective Cohort Study ◽  
Prospective Cohort

scholarly journals The INTREST registry: protocol of a multicenter prospective cohort study of predictors of women’s response to integrative breast cancer treatment

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidemarie Haller ◽  
Petra Voiß ◽  
Holger Cramer ◽  
Anna Paul ◽  
Mattea Reinisch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Cohort Study ◽  
Cancer Treatment ◽  
Prospective Cohort Study ◽  
Cancer Care ◽  
Prospective Cohort ◽  
Breast Cancer Treatment ◽  
Cancer Data ◽  
Patient Reported

Abstract Background Cancer registries usually assess data of conventional treatments and/or patient survival. Beyond that, little is known about the influence of other predictors of treatment response related to the use of complementary therapies (CM) and lifestyle factors affecting patients’ quality and quantity of life. Methods INTREST is a prospective cohort study collecting register data at multiple German certified cancer centers, which provide individualized, integrative, in- and outpatient breast cancer care. Patient-reported outcomes and clinical cancer data of anticipated N = 715 women with pTNM stage I-III breast cancer are collected using standardized case report forms at the time of diagnosis, after completing neo−/adjuvant chemotherapy, after completing adjuvant therapy (with the exception of endocrine therapy) as well as 1, 2, 5, and 10 years after baseline. Endpoints for multivariable prediction models are quality of life, fatigue, treatment adherence, and progression-based outcomes/survival. Predictors include the study center, sociodemographic characteristics, histologic cancer and comorbidity data, performance status, stress perception, depression, anxiety, sleep quality, spirituality, social support, physical activity, diet behavior, type of conventional treatments, use of and belief in CM treatments, and participation in a clinical trial. Safety is recorded following the Common Terminology Criteria for Adverse Events. Discussion This trial is currently recruiting participants. Future analyses will allow to identify predictors of short- and long-term response to integrative breast cancer treatment in women, which, in turn, may improve cancer care as well as quality and quantity of life with cancer. Trial registration German Clinical Trial Register DRKS00014852. Retrospectively registered at July 4th, 2018.

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