Economic and Social Disparities and Breast Cancer
a study on Breast Cancer
Precariousness is a multifactorial concept that can be broken down in the form of economic insecurity, and / or social insecurity and / or territorial insecurity. Precariousness has an impact on health that is difficult to assess precisely because it also impacts on other factors that may themselves influence health. Therefore, the understanding of the impact of precariousness on health involves studying individuals in their context. Our study is designed to assess the impact of precariousness on the history of breast cancer, on care pathways, on treatment and rehabilitation in a multidisciplinary contextual analysis. Indeed, the socio -economic and geographical inequalities affect the history of breast cancer, treatment and its delay and post- treatment rehabilitation. The main objective of this project is to compare the stage of disease at diagnosis (according to the TNM classification) in deprived and non deprived patients. The secondary objectives are to compare in the two groups - the socio-economic and geographical inequalities - the direct and indirect costs related to the management, the out-of pocket costs and to describe, based on individual inequalities identified, the pathway of care of the patient. These objectives will be pursued in the framework of an observational cohort study, prospective, multicenter (Ile de France) comparative exposed / unexposed category. Each precarious patient will be matched to a non- precarious patient in the same age group, regardless of the center. The study will include any patient resident in Ile de France seeking treatment for breast cancer, regardless of the stage.
Breast Cancer and Precariousness: Influence of Socio-demographic Inequalities in Cancer Stage at Diagnosis, Treatment Management and Rehabilitation in the Ile de France Area
All patients seeking treatment for breast cancer, regardless of the stage, can be included in the study. Three scores of precariousness will be applied to all patients (EPICES score, Pascal score and the European Deprivation Index). Patients identified as precarious by at least one of those three scales will be in the exposed group. The others will be in the non-exposed group.
Baseline assessment T0:
Are required only the clinical examination and radiological evaluation with the tumor size and node involvement according to TNM classification. A questionnaire will be distributed including EPICES score, Pascal score and European Deprivation Index. The baseline questionnaire will also assess the socio-economic characteristics of patients and the care trajectory before arriving in the center (see appendix).
The following questionnaire will be distributed during a consultation that is scheduled in the routine care. There will be no additional consultation imposed on the patient.
- T1: questionnaire at 3 months after inclusion
- T2: questionnaire at 6 months after inclusion
- T3: questionnaire at 12 months after inclusion
Questionnaires will be focused on direct-costs and out-of-pocket costs, socio-economical characteristics, rehabilitation, return to work.
Breast Cancer precariousness care pathways
You can join if…
Open to females ages 18 years and up
- Patients ? 18 years old having a breast cancer histologically proved
You CAN'T join if...
- Patients with a history of cancer treated in the previous five years, or with another associated untreated cancer
- Hôpital Jean Verdier not yet accepting patients
Bondy, 94143, France
- Centre Hospitalier Intercommunal Créteil not yet accepting patients
Creteil, 94000, France
- Hôpital Henri Mondor not yet accepting patients
Créteil, 94010, France
- CH de Lagny sur Marne not yet accepting patients
Lagny-sur-Marne, 77400, France
- Institut de Cancérologie Hartmann not yet accepting patients
Levallois-Perret, 92300, France
- Institut Curie Hôpital de Paris not yet accepting patients
Paris, 75005, France
- Hôpital Lariboisière not yet accepting patients
Paris, 75010, France
- Hôpital Saint-Louis not yet accepting patients
Paris, 75010, France
- Hôpital Privé des Peupliers not yet accepting patients
Paris, 75013, France
- HEGP accepting new patients
Paris, 75015, France
- Hôpital Tenon not yet accepting patients
Paris, 75020, France
- Centre Hospitalier Intercommunal Poissy Saint Germain en Laye not yet accepting patients
Poissy, 78300, France
- Institut Curie Hôpital René-Huguenin site Saint-Cloud not yet accepting patients
Saint-Cloud, 92210, France
- Centre Hospitalier Delafontaine not yet accepting patients
Saint-Denis, 93200, France
- Centre Hospitalier de Versailles not yet accepting patients
Versailles, 78157, France
- accepting new patients
- Start Date
- Completion Date
- Assistance Publique - Hôpitaux de Paris
- Study Type
- Last Updated
- January 1, 2017
Please contact me about this study
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If you do not hear from the study team, please call 888-689-8273 and tell them you’re interested in study number NCT02948478.