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Breast Cancer Survival In Canada And The Usa: Meta-Analytic Evidence Of A Canadian Advantage In Low-Income Areas, Kevin M. Gorey
Breast Cancer Survival In Canada And The Usa: Meta-Analytic Evidence Of A Canadian Advantage In Low-Income Areas, Kevin M. Gorey
Social Work Publications
BACKGROUND: This study tested the hypothesis that relatively poor Canadian women with breast cancer have a survival advantage over their counterparts in the USA.
METHODS: Seventy-eight independent retrospective cohort (incidence between 1984 and 2000, followed until 2006) outcomes were synthesized. Fixed effects meta-regression models compared women with breast cancer in low-income areas of Canada and the USA.
RESULTS: Low-income Canadian women were advantaged on survival [rate ratio (RR) = 1.14; 95% confidence interval (CI) 1.13-1.15] and their advantage was even larger among women <65 years of age who are not yet eligible for Medicare coverage in the USA (RR = 1.21, 95% CI 1.18-1.24). Canadian advantages were also larger for node positive breast cancer, which may present with greater clinical and managerial discretion (RR = 1.40, 95% CI 1.30-1.50), and smaller when Hawaii, the state providing the most Canadian-like access, was the US comparator (RR = 1.12, 95% CI 1.01-1.20).
CONCLUSIONS: More inclusive health care insurance coverage in Canada vs the USA, particularly among each country's relatively …