Impacto socioeconômico nas pacientes com câncer de mama no Brasil : sub-analise de entidade familiar do estudo amazona III

Abstract

Our study aims to analyze the marital outcomes in relation to divorce or separation and its association with demographic, socioeconomic and clinicopathological factors among breast cancer (BC) survivors after 2 years of diagnosis. Data from AMAZONA III (GBECAM 0115) prospective BC study included women aged 18 years or older diagnosed with histologically proven invasive BC from January 2016 to March 2018 in 23 Institutions in Brazil. Marital status was collected as a dichotomous variable (married or living in common-law marriage vs. no formal relationship) at baseline, year 1 and 2 of follow-up. A total of 599 were included, median age at diagnosis was 51 years, 52.9% (N=317) were postmenopausal and 88.7% (N=532) had children. From the 599 patients married or living in common-law at baseline, the divorce or separation occurred with 31 (5.1%) at 1 year of follow-up and 35 (5.8%) patients at 2 years of follow-up. Patients with public health insurance coverage (8.1% vs. 3.1%; RR 3.49, 95% CI 0.84-14.4, p=0.007) and monthly household income less than 2 minimum wages (10% vs. 3.3%; RR 2.97, 95% CI 0.89-9.85, p=0.034) were at high risk of divorce or separation. In the multivariable analysis public health insurance coverage was the only independent factor associate with divorce or separation at 2 years of follow-up (p=0.059). Breast cancer diagnosis does not appear to be associated with significant change in marital status. Patients with lower socioeconomic level and covered by public health system are at increased risk of divorce and separation.