The influence of socio-economic status on the fulfillment of Saint-Gallen recommendations for early-stage breast cancer

Abstract

Background: Socio-economic status (SES) is related to breast cancer diagnosis and prognosis. We study if SES of the participants is related to the adequacy of the treatment according to Saint Gallen consensus in Spanish women. Methods: Breast cancer cohort was assembled from incident cases from MCC-Spain and prospective followed-up afterwards. Participants were then classified according to the consensus. Association between SES and Saint Gallen fulfillment was analyzed using multinomial logistic regression, adjusting for clinicopathological variables. Results: 1110 patients in stages I and II were included. Women with university studies were twice as likely to receive over Saint-Gallen therapies (RRR = 2.27, 95%CI 1.26 – 4.09). We observed a 14% increase in the chances of being over Saint-Gallen per point of the SES score (RRR per point 1.14, 95%CI 1.03 – 1.25). In the simplified SES score, women at higher SES were over Saint-Gallen twice as those at lower SES (RRR 2.12, 95%CI 1.29 – 3.48). Conclusions: Women at higher SES more often received over Saint-Gallen therapies. Being at lower SES was not associated with over or under Saint Gallen treatment. Further analyses are needed to understand the influence of these differences on the overall survival as well as its potential unwanted side effects.