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Ageism and surgical treatment of breast cancer in Italian hospitals

Di Rosa, Mirko; Chiatti, Carlos LU ; Rimland, Joseph M.; Capasso, Marina; Scandali, Valerio M.; Prospero, Emilia; Corsonello, Andrea and Lattanzio, Fabrizia (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.

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author
publishing date
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
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
2018-11-21 21:41:01
@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 &lt;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},
  keyword      = {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},
  volume       = {30},
  year         = {2018},
}