In this study, we assessed the influence of area-based socioeconomic deprivation on the incidence of invasive breast cancer (BC) in France, according to stage at diagnosis. All women from six mainland French departments, aged 15+ years, and diagnosed with a primary invasive breast carcinoma between 2008 and 2015 were included (n= 33,298). Area-based socioeconomic deprivation was determined using the French version of the European Deprivation Index. Age-standardized incidence rates (ASIR) by socioeconomic deprivation and stage at diagnosis were compared estimating incidence rate ratios (IRRs) adjusted for age at diagnosis and rurality of residence. Compared to the most affluent areas, significantly lower IRRs were found in the most deprived areas for all-stages (0.85, 95% CI 0.81–0.89), stage I (0.77, 95% CI 0.72–0.82), and stage II (0.84, 95% CI 0.78–0.90). On the contrary, for stages III–IV, significantly higher IRRs (1.18, 95% CI 1.08–1.29) were found in the most deprived areas. These findings provide a possible explanation to similar or higher mortality rates, despite overall lower incidence rates, observed in women living in more deprived areas when compared to their affluent counterparts. Socioeconomic inequalities in access to healthcare services, including screening, could be plausible explanations for this phenomenon, underlying the need for further research.
本研究评估了法国不同社会经济贫困程度地区对浸润性乳腺癌（BC）发病率的影响，并依据诊断时的分期进行分析。研究对象为2008年至2015年间法国本土六个省份所有15岁及以上、被诊断为原发性浸润性乳腺癌的女性（n=33,298）。地区社会经济贫困程度采用欧洲贫困指数的法国版本进行评定。通过计算经诊断年龄和居住地乡村化程度调整后的发病率比（IRRs），比较了不同社会经济贫困程度及诊断分期下的年龄标准化发病率（ASIR）。与最富裕地区相比，最贫困地区的全分期乳腺癌发病率显著较低（IRR=0.85，95% CI 0.81–0.89），其中Ⅰ期（IRR=0.77，95% CI 0.72–0.82）和Ⅱ期（IRR=0.84，95% CI 0.78–0.90）尤为明显。相反，在最贫困地区，Ⅲ–Ⅳ期乳腺癌的发病率显著更高（IRR=1.18，95% CI 1.08–1.29）。这些发现为以下现象提供了可能的解释：尽管贫困地区女性的乳腺癌总体发病率较低，但其死亡率却与富裕地区相似甚至更高。医疗保健服务（包括筛查）获取方面的社会经济不平等可能是导致这一现象的原因，这凸显了进一步研究的必要性。
肿瘤(癌症)患者之家