Predictive factors of the survival of women with invasive breast cancer in French Guiana: the burden of health inequalities

Tristan Roué (1) , Sylvain Labbé (1, 2) , Sophie Belliardo (1) , Juliette Plenet (1) , Maylis Douine (3, 2) , Mathieu Nacher (3, 2)

1 Registre des Cancers de Guyane
2 Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
3 CIC - Antilles Guyane - Centre d'Investigation Clinique Antilles-Guyane

This study aimed to compare the relative survival of patients with invasive breast cancer between women from French Guiana (a French territory in South America) and metropolitan France. No study hadever compared survival of breast cancer on the basis of immigrant status in France. Our study underlined that access to care for migrants is challenging whichwgenerates health inequalities. Background The prognosis of breast cancer in French Guiana is worse than in France with 23 deaths per 100 incident cases against 17 per 100 in metropolitan France. This study aimed to compare relative survival of patients with invasive breast cancer (IBC) between women from French Guiana and metropolitan France and to determine risk factors influencing breast cancer survival in French Guiana. Materials and methods Data were collected from the Cancer registry of French Guiana. We comparedthe relative survival of women with IBC between French Guiana and metropolitan France. We used Cox's proportional hazard regression to evaluate the effect of prognostic factors on cancer-specific mortality in French Guiana. Results We included all 269 cases of IBC in women diagnosed in French Guiana between 2003 and 2009. The overall 5-year relative survival rate of patients with IBC was 79% in French Guiana and 86% in metropolitan France. The place of birth (foreign country versus French territory), the tumor stage at the time of diagnosis, the mode of diagnosis (symptoms versus screening), the presence of hormone receptors in the tumor and the histologic type were the variables associated with survival differences. None of the other study variables were significantly associated with prognosis. Conclusion Access to care for migrants is challenging,which leads to health inequalities. Early detection through prevention programs is crucial to increaseIBC survival notably for foreign-born patients.

Mots clés: Breast cancer; Survival; Immigrant; South America Word count : 2278

Domaines: Santé publique et épidémiologie

Tristan Roué, Sylvain Labbé, Sophie Belliardo, Juliette Plenet, Maylis Douine, et al.. Predictive factors of the survival of women with invasive breast cancer in French Guiana: the burden of health inequalities. Clinical Breast Cancer, 2016, ⟨10.1016/j.clbc.2016.02.017⟩. ⟨hal-01288657⟩