Metastatic breast cancer incidence, site and survival in Australia, 2001-2016: a population-based health record linkage study protocol
Metastatic breast cancer incidence, site and survival in Australia, 2001-2016: a population-based health record linkage study protocol
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DOI：
10.1136/bmjopen-2018-026414
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发表时间：
2019-06-01
期刊：
影响因子：
2.9
通讯作者：
Houssami, Nehmat
中科院分区：
文献类型：
--
作者：
Lord, Sarah J.;Kiely, Belinda E.;Houssami, Nehmat
在过去的二十年中，早期和转移性乳腺癌（BC）的全身治疗进展改善了患者的生存率，但其对人群水平转移性疾病结局的影响尚未得到很好的描述。本研究的目的是调查2001-2002年与2006- 2007年首次诊断为乳腺癌的妇女转移性疾病的发生率、部位和生存率的变化。方法和分析2001-2002年和2006-2007年在新南威尔士州（NSW）癌症登记处登记的首次原发性浸润性乳腺癌妇女的基于人群的回顾性队列研究。我们将使用来自新南威尔士州医院，分发药物，门诊服务和死亡登记的相关记录来确定：妇女的人口统计学和肿瘤特征;接受的治疗;首次远处转移的时间;首次转移的部位和生存期。我们将使用Kaplan-Meier方法，通过初始诊断时的疾病程度、转移部位和治疗定义的肿瘤受体类型（激素受体阳性、人表皮生长因子受体-2阳性、三阴性），估计远处转移的累积发生率、无远处复发间期和转移后生存期。我们将使用考克斯比例风险回归来估计预后因素的相对影响，我们将比较居住地区和地区社会经济地位的系统治疗模式，以检查获得医疗保健的公平性。伦理和传播研究伦理委员会批准由澳大利亚健康和福利研究所（#EO2017/2/255），新南威尔士州人口和卫生服务（#HREC/17/CIPHS/19）和澳大利亚圣母大学（#017144S）。我们将通过国家和国际会议报告向肿瘤学，BC消费者和流行病学受众传播研究结果，向BC消费者团体提供摘要，并在国际同行评审的肿瘤学和癌症流行病学期刊上发表文章。
Introduction Advances in systemic therapy for early and metastatic breast cancer (BC) over the last two decades have improved patients' survival, but their impact on metastatic disease outcomes at a population level is not well described. The aim of this study is to investigate changes in the incidence, site and survival of metastatic disease for women with a first diagnosis of BC in 2001-2002 vs 2006-2007.Methods and analysis Population-based retrospective cohort study of women with first primary invasive BC registered in the New South Wales (NSW) Cancer Registry in 2001-2002 and 2006-2007. We will use linked records from NSW hospitals, dispensed medicines, outpatient services and death registrations to determine: women's demographic and tumour characteristics; treatments received; time to first distant metastasis; site of first metastasis and survival. We will use the Kaplan-Meier method to estimate cumulative incidence of distant metastasis, distant recurrence-free interval and postmetastasis survival by extent of disease at initial diagnosis, site of metastasis and treatment-defined tumour receptor type (hormone receptor-positive, human epidermal growth factor receptor-2-positive, triple negative). We will use Cox proportional hazards regression to estimate the relative effects of prognostic factors, and we will compare systemic therapy patterns by area-of-residence and area-level socioeconomic status to examine equity of access to healthcare.Ethics and dissemination Research ethics committee approval was granted by the Australian Institute of Health and Welfare (#EO2017/2/255), NSW Population and Health Services (#HREC/17/CIPHS/19) and University of Notre Dame Australia (#017144S). We will disseminate research findings to oncology, BC consumer and epidemiology audiences through national and international conference presentations, lay summaries to BC consumer groups and publications in international peer-reviewed oncology and cancer epidemiology journals.