Spatial and temporal changes of breast-conserving surgery rates and its influential factors among Chinese patients with breast cancer from 2013 to 2019: a registry-based study
Objective Our study aims to evaluate the spatial and temporal changes of breast-conserving surgery (BCS) rates and influential factors of BCS in Guangdong Province, China.Design, setting and participants This registry-based cohort study analysed the data of patients of all age groups, from the medic...
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/1/e089188.full |
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| author | Pengpeng Ye Yuan Yang Wei Hu Lingyan Dai Erwei Song Shunrong Li Liling Zhu Kai Chen Yanjie Xu Xiaoyu Wang Jianli Zhao Jianrong He Queran Lin Tongrui Shang Xiujuan Gui Ziliang Zhong Qianru Chen Qing Yan Xiaoliang Huang Zijian Liang |
| author_facet | Pengpeng Ye Yuan Yang Wei Hu Lingyan Dai Erwei Song Shunrong Li Liling Zhu Kai Chen Yanjie Xu Xiaoyu Wang Jianli Zhao Jianrong He Queran Lin Tongrui Shang Xiujuan Gui Ziliang Zhong Qianru Chen Qing Yan Xiaoliang Huang Zijian Liang |
| author_sort | Pengpeng Ye |
| collection | DOAJ |
| description | Objective Our study aims to evaluate the spatial and temporal changes of breast-conserving surgery (BCS) rates and influential factors of BCS in Guangdong Province, China.Design, setting and participants This registry-based cohort study analysed the data of patients of all age groups, from the medical record cover page, which was mandatorily collected for inpatients by the Health Administrative Department of Guangdong Province, China. Patients with non-metastatic breast cancer, who underwent breast surgery between 2013 and 2019, were included.Main outcomes and measures We analysed the BCS rate in Guangdong Province between 2013 and 2019. Logistic regression was applied to investigate the association between patient-level influential factors and BCS, respectively. We used restricted cubic spline regression to model the non-linear association between hospital volume rank with BCS rate. Linear regression was used to evaluate the association between city-level parameters with BCS rate of each city.Results A total of 93 521 patients with non-metastatic breast cancer, who underwent breast surgery, were included in the analyses. Among them, 10 949 (11.7%) had BCS, with the BCS rates increasing from 0.8% in 2013 to 19.2% in 2019. Patients who were older (vs <40 years, 40–49 years: adjusted OR 0.72, 95% CI 0.68 to 0.76; 50–59 years: 0.51, 95% CI 0.48 to 0.54; ≥60 years: 0.37, 95% CI 0.35 to 0.40) and married (vs unmarried, 0.64, 95% CI 0.59 to 0.70) were less likely to undergo BCS. Patients who were employed (vs unemployed, 1.58, 95% CI 1.49 to 1.68), received cross-city surgery (vs local surgery, 1.37, 95% CI 1.31 to 1.44), lived in a high-income city (vs low-income city, β=4.40, 95% CI 1.55 to 7.24) or in a city with a higher number of physicians per 100 000 residents (0.57, 95% CI 0.31 to 0.82) were more likely to receive BCS.Conclusions and relevance This study suggests a significant increase in BCS rates from 2013 to 2019 in Guangdong, China. Promotion of BCS is needed, particularly among older patients, lower-volume hospitals and economically underdeveloped areas. Healthcare system should be prepared to support the increased awareness of seeking BCS among younger patients with breast cancer by improving the availability of radiotherapy, multidisciplinary team and patients’ education programme. |
| format | Article |
| id | doaj-art-fe44d38c28f44138a23cba84f3fe794d |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-fe44d38c28f44138a23cba84f3fe794d2025-02-03T04:25:15ZengBMJ Publishing GroupBMJ Open2044-60552025-02-0115110.1136/bmjopen-2024-089188Spatial and temporal changes of breast-conserving surgery rates and its influential factors among Chinese patients with breast cancer from 2013 to 2019: a registry-based studyPengpeng Ye0Yuan Yang1Wei Hu2Lingyan Dai3Erwei Song4Shunrong Li5Liling Zhu6Kai Chen7Yanjie Xu8Xiaoyu Wang9Jianli Zhao10Jianrong He11Queran Lin12Tongrui Shang13Xiujuan Gui14Ziliang Zhong15Qianru Chen16Qing Yan17Xiaoliang Huang18Zijian Liang19National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, ChinaHealth Data (Beijing) Technology Co Ltd, Guangzhou, ChinaGovernment Affairs Service Centre, Health Commission of Guangdong Province, Guangzhou, Guangdong, ChinaHealth Data (Beijing) Technology Co Ltd, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Malignant Tumour Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Malignant Tumour Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaBreast Tumour Centre, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. ChinaGuangdong Provincial Key Laboratory of Malignant Tumour Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaHealth Data (Beijing) Technology Co Ltd, Guangzhou, ChinaDepartment of Clinical Medicine, KingMed Diagnostic Laboratory, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Malignant Tumour Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDivision of Birth Cohort Study, Guangzhou Women and Children`s Medical Center, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Malignant Tumour Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Malignant Tumour Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Malignant Tumour Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaHealth Data (Beijing) Technology Co Ltd, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Malignant Tumour Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaHealth Data (Beijing) Technology Co Ltd, Guangzhou, ChinaGovernment Affairs Service Centre, Health Commission of Guangdong Province, Guangzhou, Guangdong, ChinaGovernment Affairs Service Centre, Health Commission of Guangdong Province, Guangzhou, Guangdong, ChinaObjective Our study aims to evaluate the spatial and temporal changes of breast-conserving surgery (BCS) rates and influential factors of BCS in Guangdong Province, China.Design, setting and participants This registry-based cohort study analysed the data of patients of all age groups, from the medical record cover page, which was mandatorily collected for inpatients by the Health Administrative Department of Guangdong Province, China. Patients with non-metastatic breast cancer, who underwent breast surgery between 2013 and 2019, were included.Main outcomes and measures We analysed the BCS rate in Guangdong Province between 2013 and 2019. Logistic regression was applied to investigate the association between patient-level influential factors and BCS, respectively. We used restricted cubic spline regression to model the non-linear association between hospital volume rank with BCS rate. Linear regression was used to evaluate the association between city-level parameters with BCS rate of each city.Results A total of 93 521 patients with non-metastatic breast cancer, who underwent breast surgery, were included in the analyses. Among them, 10 949 (11.7%) had BCS, with the BCS rates increasing from 0.8% in 2013 to 19.2% in 2019. Patients who were older (vs <40 years, 40–49 years: adjusted OR 0.72, 95% CI 0.68 to 0.76; 50–59 years: 0.51, 95% CI 0.48 to 0.54; ≥60 years: 0.37, 95% CI 0.35 to 0.40) and married (vs unmarried, 0.64, 95% CI 0.59 to 0.70) were less likely to undergo BCS. Patients who were employed (vs unemployed, 1.58, 95% CI 1.49 to 1.68), received cross-city surgery (vs local surgery, 1.37, 95% CI 1.31 to 1.44), lived in a high-income city (vs low-income city, β=4.40, 95% CI 1.55 to 7.24) or in a city with a higher number of physicians per 100 000 residents (0.57, 95% CI 0.31 to 0.82) were more likely to receive BCS.Conclusions and relevance This study suggests a significant increase in BCS rates from 2013 to 2019 in Guangdong, China. Promotion of BCS is needed, particularly among older patients, lower-volume hospitals and economically underdeveloped areas. Healthcare system should be prepared to support the increased awareness of seeking BCS among younger patients with breast cancer by improving the availability of radiotherapy, multidisciplinary team and patients’ education programme.https://bmjopen.bmj.com/content/15/1/e089188.full |
| spellingShingle | Pengpeng Ye Yuan Yang Wei Hu Lingyan Dai Erwei Song Shunrong Li Liling Zhu Kai Chen Yanjie Xu Xiaoyu Wang Jianli Zhao Jianrong He Queran Lin Tongrui Shang Xiujuan Gui Ziliang Zhong Qianru Chen Qing Yan Xiaoliang Huang Zijian Liang Spatial and temporal changes of breast-conserving surgery rates and its influential factors among Chinese patients with breast cancer from 2013 to 2019: a registry-based study BMJ Open |
| title | Spatial and temporal changes of breast-conserving surgery rates and its influential factors among Chinese patients with breast cancer from 2013 to 2019: a registry-based study |
| title_full | Spatial and temporal changes of breast-conserving surgery rates and its influential factors among Chinese patients with breast cancer from 2013 to 2019: a registry-based study |
| title_fullStr | Spatial and temporal changes of breast-conserving surgery rates and its influential factors among Chinese patients with breast cancer from 2013 to 2019: a registry-based study |
| title_full_unstemmed | Spatial and temporal changes of breast-conserving surgery rates and its influential factors among Chinese patients with breast cancer from 2013 to 2019: a registry-based study |
| title_short | Spatial and temporal changes of breast-conserving surgery rates and its influential factors among Chinese patients with breast cancer from 2013 to 2019: a registry-based study |
| title_sort | spatial and temporal changes of breast conserving surgery rates and its influential factors among chinese patients with breast cancer from 2013 to 2019 a registry based study |
| url | https://bmjopen.bmj.com/content/15/1/e089188.full |
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