Relation between socioeconomic deprivation and pathological prognostic factors in women with breast cancer.

OBJECTIVE: To investigate the relation between socioeconomic deprivation and pathological prognostic factors in women with breast cancer as a possible explanation for socioeconomic differences in survival. DESIGN: Retrospective analysis of data from cancer registry and from pathology and biochemistry records. SETTING: Catchment areas of two large teaching hospitals in Glasgow. SUBJECTS: 1361 women aged under 75 who had breast cancer diagnosed between 1980 and 1987. MAIN OUTCOME MEASURES: Tumour size, axillary lymph node status, histological grade, and oestrogen receptor concentration in relation to deprivation category of area of residence. RESULTS: There was no significant relation between socioeconomic deprivation and four pathological prognostic factors: 93 (32%) women in the most affluent group presented with tumours less than 20 mm in size compared with 91 (31%) women in the most deprived group; 152 (48%) of the most affluent group presented with negative nodes compared with 129 (46%) of the most deprived group; 23 (22%) of the most affluent group presented with grade I tumours compared with 12 (17%) of the most deprived group; and 142 (51%) of the most affluent group had a low oestrogen receptor concentration at presentation compared with 148 (52%) of the most deprived group. None of these differences was statistically significant. CONCLUSIONS: Differences in survival from breast cancer by socioeconomic deprivation category could not be accounted for by differences in tumour stage or biology. Other possible explanations, such as differences in treatment or in host response, should be investigated.

Cancer of larynx in west of Scotland. A review of results and a consideration of new therapeutic approaches.

A recent epidemiological study carried out by the Cancer Intelligence Unit in Glasgow has shown: 1) there has been an increase in consumption of tobacco products and alcohol in Scotland over the past 25 years; and 2) the mortality rate from cancer of the larynx has been unchanged over that time (Fig. 1). Ayrshire, a county in the west of Scotland, has a population of 360,000 which is remarkably similar in age structure, sex and urban/rural mix to Scotland as a whole. The incidence of carcinoma of the larynx in this region has been unchanged over the 20-year period 1959-1978. The results of treatment for the period 1958-1968 were reported recently by Quayum. In this report the results of treatment of carcinoma of the larynx by radiotherapy in Ayrshire and district over the decade 1968-1978 are presented and compared with those of the previous decade. The overall survival is unchanged over the two decades 1958-68 and 1968-78. This confirms the findings of the Cancer Registry. The survival of certain stages has improved, though this may be due to changes in criteria for staging introduced in 1974. All cases in this report were staged retrospectively. Recent innovations in treatment which may improve overall survival are considered.