Ageism and surgical treatment of breast cancer in Italian hospitals
(2018) In Aging clinical and experimental research 30(2). p.139-144- Abstract
Aim: To determine if age is a factor influencing the type of breast cancer surgery (radical versus conservative) in Italy and to investigate the regional differences in breast cancer surgery clinical practice. Methods: Retrospective study is based on national hospital discharge records. The study draws on routinely collected data from hospital discharge records in Italy in 2010. The following exclusion criteria were applied: day hospital stays, patients younger than 17 years, males, patients without an ICD-9CM code indicating breast cancer and breast surgery, and repeated hospital admission of the same patient. Overall, 49,058 patient records were selected for the analysis. Results: The proportion of conservative breast cancer... (More)
Aim: To determine if age is a factor influencing the type of breast cancer surgery (radical versus conservative) in Italy and to investigate the regional differences in breast cancer surgery clinical practice. Methods: Retrospective study is based on national hospital discharge records. The study draws on routinely collected data from hospital discharge records in Italy in 2010. The following exclusion criteria were applied: day hospital stays, patients younger than 17 years, males, patients without an ICD-9CM code indicating breast cancer and breast surgery, and repeated hospital admission of the same patient. Overall, 49,058 patient records were selected for the analysis. Results: The proportion of conservative breast cancer operations was 70.9%. A greater number of women younger than 70 had undergone a breast-conserving operation compared to older women. There were regional variations ranging from a minimum in Basilicata to a maximum in Val d’Aosta. Multivariate analysis revealed that older patients with lower clinical severity were more likely to have undergone a radical operation than younger women. In addition, radical surgery was approximately twice as likely to occur in a private hospital that performed at least 50 breast cancer operations annually than in a public hospital that performed <50 breast surgeries. Conclusion: Notwithstanding increases in life expectancy and the lack of clinical evidence to support the use of age as a surrogate for co-morbid conditions and frailty, our data on breast cancer operations in Italy are consistent with the hypothesis suggesting the persistence of ageistic practice in the healthcare system.
(Less)
- author
- Di Rosa, Mirko ; Chiatti, Carlos LU ; Rimland, Joseph M. ; Capasso, Marina ; Scandali, Valerio M. ; Prospero, Emilia ; Corsonello, Andrea and Lattanzio, Fabrizia
- publishing date
- 2018-02-01
- type
- Contribution to journal
- publication status
- published
- keywords
- Ageism, Breast cancer surgery, Health inequalities
- in
- Aging clinical and experimental research
- volume
- 30
- issue
- 2
- pages
- 139 - 144
- publisher
- Kurtis
- external identifiers
-
- scopus:85017121803
- pmid:28391587
- ISSN
- 1594-0667
- DOI
- 10.1007/s40520-017-0757-0
- language
- English
- LU publication?
- no
- id
- fd9e57db-2bac-4b47-a5a6-fbf3efce52eb
- date added to LUP
- 2018-08-07 14:57:19
- date last changed
- 2024-07-08 17:17:44
@article{fd9e57db-2bac-4b47-a5a6-fbf3efce52eb, abstract = {{<p>Aim: To determine if age is a factor influencing the type of breast cancer surgery (radical versus conservative) in Italy and to investigate the regional differences in breast cancer surgery clinical practice. Methods: Retrospective study is based on national hospital discharge records. The study draws on routinely collected data from hospital discharge records in Italy in 2010. The following exclusion criteria were applied: day hospital stays, patients younger than 17 years, males, patients without an ICD-9CM code indicating breast cancer and breast surgery, and repeated hospital admission of the same patient. Overall, 49,058 patient records were selected for the analysis. Results: The proportion of conservative breast cancer operations was 70.9%. A greater number of women younger than 70 had undergone a breast-conserving operation compared to older women. There were regional variations ranging from a minimum in Basilicata to a maximum in Val d’Aosta. Multivariate analysis revealed that older patients with lower clinical severity were more likely to have undergone a radical operation than younger women. In addition, radical surgery was approximately twice as likely to occur in a private hospital that performed at least 50 breast cancer operations annually than in a public hospital that performed <50 breast surgeries. Conclusion: Notwithstanding increases in life expectancy and the lack of clinical evidence to support the use of age as a surrogate for co-morbid conditions and frailty, our data on breast cancer operations in Italy are consistent with the hypothesis suggesting the persistence of ageistic practice in the healthcare system.</p>}}, author = {{Di Rosa, Mirko and Chiatti, Carlos and Rimland, Joseph M. and Capasso, Marina and Scandali, Valerio M. and Prospero, Emilia and Corsonello, Andrea and Lattanzio, Fabrizia}}, issn = {{1594-0667}}, keywords = {{Ageism; Breast cancer surgery; Health inequalities}}, language = {{eng}}, month = {{02}}, number = {{2}}, pages = {{139--144}}, publisher = {{Kurtis}}, series = {{Aging clinical and experimental research}}, title = {{Ageism and surgical treatment of breast cancer in Italian hospitals}}, url = {{http://dx.doi.org/10.1007/s40520-017-0757-0}}, doi = {{10.1007/s40520-017-0757-0}}, volume = {{30}}, year = {{2018}}, }