Travel time and distance to health care only partially account for the ethnic inequalities in cervical cancer stage at diagnosis and mortality in New Zealand
Abstract Objective: To investigate whether travel time or distance to the nearest general practitioner (GP) and/or cancer centre accounts for the ethnic differences in cervical cancer screening, stage at diagnosis and mortality in New Zealand (NZ). Methods: The study involved 1,594 cervical cancer c...
Ausführliche Beschreibung
Autor*in: |
Naomi Brewer [verfasserIn] Neil Pearce [verfasserIn] Peter Day [verfasserIn] Barry Borman [verfasserIn] |
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Format: |
E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2012 |
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Übergeordnetes Werk: |
In: Australian and New Zealand Journal of Public Health - Elsevier, 2018, 36(2012), 4, Seite 335-342 |
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Übergeordnetes Werk: |
volume:36 ; year:2012 ; number:4 ; pages:335-342 |
Links: |
Link aufrufen |
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DOI / URN: |
10.1111/j.1753-6405.2012.00843.x |
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Katalog-ID: |
DOAJ006953859 |
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520 | |a Abstract Objective: To investigate whether travel time or distance to the nearest general practitioner (GP) and/or cancer centre accounts for the ethnic differences in cervical cancer screening, stage at diagnosis and mortality in New Zealand (NZ). Methods: The study involved 1,594 cervical cancer cases registered between 1994 and 2005. Travel time and distance to the GP and cancer centre were estimated using a Geographical Information System. Results: Adjustment for travel time or distance made almost no difference to ethnic differences in screening rates. Adjustment for travel time reduced the excess risk for late‐stage diagnosis in Māori (the odds ratio (OR) reduced from 2.71 (95%CI 1.98–3.72) to 2.59 (1.88–3.56), a 7% decrease) and 33% in Pacific (the OR reduced from 1.39 (0.76–2.54) to 1.26 (0.68–2.33)) women. Adjustment for travel time reduced the excess risk for mortality by 3% in Māori (the hazard ratio (HR) reduced from 1.59 (1.21–2.08) to 1.57 (1.19–2.06)) and 13% in Pacific (the HR reduced from 1.92 (1.20–3.08) to 1.80 (1.11–2.91)) women. Similar findings were observed when using travel distance rather than travel time. Conclusions: Travel time and distance are only weakly associated with cervical cancer screening, stage at diagnosis and mortality in NZ. However, travel time may account for a small proportion of the ethnic differences in stage at diagnosis, and to a lesser extent mortality, particularly for Pacific women. Implications: The findings suggest that there may be ethnic variations in access to treatment or treatment quality, which may be related to travel time. | ||
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10.1111/j.1753-6405.2012.00843.x doi (DE-627)DOAJ006953859 (DE-599)DOAJf098bee056bc40769444bcf8738bfc1c DE-627 ger DE-627 rakwb eng RA1-1270 Naomi Brewer verfasserin aut Travel time and distance to health care only partially account for the ethnic inequalities in cervical cancer stage at diagnosis and mortality in New Zealand 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Objective: To investigate whether travel time or distance to the nearest general practitioner (GP) and/or cancer centre accounts for the ethnic differences in cervical cancer screening, stage at diagnosis and mortality in New Zealand (NZ). Methods: The study involved 1,594 cervical cancer cases registered between 1994 and 2005. Travel time and distance to the GP and cancer centre were estimated using a Geographical Information System. Results: Adjustment for travel time or distance made almost no difference to ethnic differences in screening rates. Adjustment for travel time reduced the excess risk for late‐stage diagnosis in Māori (the odds ratio (OR) reduced from 2.71 (95%CI 1.98–3.72) to 2.59 (1.88–3.56), a 7% decrease) and 33% in Pacific (the OR reduced from 1.39 (0.76–2.54) to 1.26 (0.68–2.33)) women. Adjustment for travel time reduced the excess risk for mortality by 3% in Māori (the hazard ratio (HR) reduced from 1.59 (1.21–2.08) to 1.57 (1.19–2.06)) and 13% in Pacific (the HR reduced from 1.92 (1.20–3.08) to 1.80 (1.11–2.91)) women. Similar findings were observed when using travel distance rather than travel time. Conclusions: Travel time and distance are only weakly associated with cervical cancer screening, stage at diagnosis and mortality in NZ. However, travel time may account for a small proportion of the ethnic differences in stage at diagnosis, and to a lesser extent mortality, particularly for Pacific women. Implications: The findings suggest that there may be ethnic variations in access to treatment or treatment quality, which may be related to travel time. Uterine cervical neoplasms ethnicity geographical variation inequalities New Zealand Public aspects of medicine Neil Pearce verfasserin aut Peter Day verfasserin aut Barry Borman verfasserin aut In Australian and New Zealand Journal of Public Health Elsevier, 2018 36(2012), 4, Seite 335-342 (DE-627)341908045 (DE-600)2070571-2 17536405 nnns volume:36 year:2012 number:4 pages:335-342 https://doi.org/10.1111/j.1753-6405.2012.00843.x kostenfrei https://doaj.org/article/f098bee056bc40769444bcf8738bfc1c kostenfrei https://doi.org/10.1111/j.1753-6405.2012.00843.x kostenfrei https://doaj.org/toc/1326-0200 Journal toc kostenfrei https://doaj.org/toc/1753-6405 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_184 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 36 2012 4 335-342 |
spelling |
10.1111/j.1753-6405.2012.00843.x doi (DE-627)DOAJ006953859 (DE-599)DOAJf098bee056bc40769444bcf8738bfc1c DE-627 ger DE-627 rakwb eng RA1-1270 Naomi Brewer verfasserin aut Travel time and distance to health care only partially account for the ethnic inequalities in cervical cancer stage at diagnosis and mortality in New Zealand 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Objective: To investigate whether travel time or distance to the nearest general practitioner (GP) and/or cancer centre accounts for the ethnic differences in cervical cancer screening, stage at diagnosis and mortality in New Zealand (NZ). Methods: The study involved 1,594 cervical cancer cases registered between 1994 and 2005. Travel time and distance to the GP and cancer centre were estimated using a Geographical Information System. Results: Adjustment for travel time or distance made almost no difference to ethnic differences in screening rates. Adjustment for travel time reduced the excess risk for late‐stage diagnosis in Māori (the odds ratio (OR) reduced from 2.71 (95%CI 1.98–3.72) to 2.59 (1.88–3.56), a 7% decrease) and 33% in Pacific (the OR reduced from 1.39 (0.76–2.54) to 1.26 (0.68–2.33)) women. Adjustment for travel time reduced the excess risk for mortality by 3% in Māori (the hazard ratio (HR) reduced from 1.59 (1.21–2.08) to 1.57 (1.19–2.06)) and 13% in Pacific (the HR reduced from 1.92 (1.20–3.08) to 1.80 (1.11–2.91)) women. Similar findings were observed when using travel distance rather than travel time. Conclusions: Travel time and distance are only weakly associated with cervical cancer screening, stage at diagnosis and mortality in NZ. However, travel time may account for a small proportion of the ethnic differences in stage at diagnosis, and to a lesser extent mortality, particularly for Pacific women. Implications: The findings suggest that there may be ethnic variations in access to treatment or treatment quality, which may be related to travel time. Uterine cervical neoplasms ethnicity geographical variation inequalities New Zealand Public aspects of medicine Neil Pearce verfasserin aut Peter Day verfasserin aut Barry Borman verfasserin aut In Australian and New Zealand Journal of Public Health Elsevier, 2018 36(2012), 4, Seite 335-342 (DE-627)341908045 (DE-600)2070571-2 17536405 nnns volume:36 year:2012 number:4 pages:335-342 https://doi.org/10.1111/j.1753-6405.2012.00843.x kostenfrei https://doaj.org/article/f098bee056bc40769444bcf8738bfc1c kostenfrei https://doi.org/10.1111/j.1753-6405.2012.00843.x kostenfrei https://doaj.org/toc/1326-0200 Journal toc kostenfrei https://doaj.org/toc/1753-6405 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_184 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 36 2012 4 335-342 |
allfields_unstemmed |
10.1111/j.1753-6405.2012.00843.x doi (DE-627)DOAJ006953859 (DE-599)DOAJf098bee056bc40769444bcf8738bfc1c DE-627 ger DE-627 rakwb eng RA1-1270 Naomi Brewer verfasserin aut Travel time and distance to health care only partially account for the ethnic inequalities in cervical cancer stage at diagnosis and mortality in New Zealand 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Objective: To investigate whether travel time or distance to the nearest general practitioner (GP) and/or cancer centre accounts for the ethnic differences in cervical cancer screening, stage at diagnosis and mortality in New Zealand (NZ). Methods: The study involved 1,594 cervical cancer cases registered between 1994 and 2005. Travel time and distance to the GP and cancer centre were estimated using a Geographical Information System. Results: Adjustment for travel time or distance made almost no difference to ethnic differences in screening rates. Adjustment for travel time reduced the excess risk for late‐stage diagnosis in Māori (the odds ratio (OR) reduced from 2.71 (95%CI 1.98–3.72) to 2.59 (1.88–3.56), a 7% decrease) and 33% in Pacific (the OR reduced from 1.39 (0.76–2.54) to 1.26 (0.68–2.33)) women. Adjustment for travel time reduced the excess risk for mortality by 3% in Māori (the hazard ratio (HR) reduced from 1.59 (1.21–2.08) to 1.57 (1.19–2.06)) and 13% in Pacific (the HR reduced from 1.92 (1.20–3.08) to 1.80 (1.11–2.91)) women. Similar findings were observed when using travel distance rather than travel time. Conclusions: Travel time and distance are only weakly associated with cervical cancer screening, stage at diagnosis and mortality in NZ. However, travel time may account for a small proportion of the ethnic differences in stage at diagnosis, and to a lesser extent mortality, particularly for Pacific women. Implications: The findings suggest that there may be ethnic variations in access to treatment or treatment quality, which may be related to travel time. Uterine cervical neoplasms ethnicity geographical variation inequalities New Zealand Public aspects of medicine Neil Pearce verfasserin aut Peter Day verfasserin aut Barry Borman verfasserin aut In Australian and New Zealand Journal of Public Health Elsevier, 2018 36(2012), 4, Seite 335-342 (DE-627)341908045 (DE-600)2070571-2 17536405 nnns volume:36 year:2012 number:4 pages:335-342 https://doi.org/10.1111/j.1753-6405.2012.00843.x kostenfrei https://doaj.org/article/f098bee056bc40769444bcf8738bfc1c kostenfrei https://doi.org/10.1111/j.1753-6405.2012.00843.x kostenfrei https://doaj.org/toc/1326-0200 Journal toc kostenfrei https://doaj.org/toc/1753-6405 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_184 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 36 2012 4 335-342 |
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10.1111/j.1753-6405.2012.00843.x doi (DE-627)DOAJ006953859 (DE-599)DOAJf098bee056bc40769444bcf8738bfc1c DE-627 ger DE-627 rakwb eng RA1-1270 Naomi Brewer verfasserin aut Travel time and distance to health care only partially account for the ethnic inequalities in cervical cancer stage at diagnosis and mortality in New Zealand 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Objective: To investigate whether travel time or distance to the nearest general practitioner (GP) and/or cancer centre accounts for the ethnic differences in cervical cancer screening, stage at diagnosis and mortality in New Zealand (NZ). Methods: The study involved 1,594 cervical cancer cases registered between 1994 and 2005. Travel time and distance to the GP and cancer centre were estimated using a Geographical Information System. Results: Adjustment for travel time or distance made almost no difference to ethnic differences in screening rates. Adjustment for travel time reduced the excess risk for late‐stage diagnosis in Māori (the odds ratio (OR) reduced from 2.71 (95%CI 1.98–3.72) to 2.59 (1.88–3.56), a 7% decrease) and 33% in Pacific (the OR reduced from 1.39 (0.76–2.54) to 1.26 (0.68–2.33)) women. Adjustment for travel time reduced the excess risk for mortality by 3% in Māori (the hazard ratio (HR) reduced from 1.59 (1.21–2.08) to 1.57 (1.19–2.06)) and 13% in Pacific (the HR reduced from 1.92 (1.20–3.08) to 1.80 (1.11–2.91)) women. Similar findings were observed when using travel distance rather than travel time. Conclusions: Travel time and distance are only weakly associated with cervical cancer screening, stage at diagnosis and mortality in NZ. However, travel time may account for a small proportion of the ethnic differences in stage at diagnosis, and to a lesser extent mortality, particularly for Pacific women. Implications: The findings suggest that there may be ethnic variations in access to treatment or treatment quality, which may be related to travel time. Uterine cervical neoplasms ethnicity geographical variation inequalities New Zealand Public aspects of medicine Neil Pearce verfasserin aut Peter Day verfasserin aut Barry Borman verfasserin aut In Australian and New Zealand Journal of Public Health Elsevier, 2018 36(2012), 4, Seite 335-342 (DE-627)341908045 (DE-600)2070571-2 17536405 nnns volume:36 year:2012 number:4 pages:335-342 https://doi.org/10.1111/j.1753-6405.2012.00843.x kostenfrei https://doaj.org/article/f098bee056bc40769444bcf8738bfc1c kostenfrei https://doi.org/10.1111/j.1753-6405.2012.00843.x kostenfrei https://doaj.org/toc/1326-0200 Journal toc kostenfrei https://doaj.org/toc/1753-6405 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_184 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 36 2012 4 335-342 |
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10.1111/j.1753-6405.2012.00843.x doi (DE-627)DOAJ006953859 (DE-599)DOAJf098bee056bc40769444bcf8738bfc1c DE-627 ger DE-627 rakwb eng RA1-1270 Naomi Brewer verfasserin aut Travel time and distance to health care only partially account for the ethnic inequalities in cervical cancer stage at diagnosis and mortality in New Zealand 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Objective: To investigate whether travel time or distance to the nearest general practitioner (GP) and/or cancer centre accounts for the ethnic differences in cervical cancer screening, stage at diagnosis and mortality in New Zealand (NZ). Methods: The study involved 1,594 cervical cancer cases registered between 1994 and 2005. Travel time and distance to the GP and cancer centre were estimated using a Geographical Information System. Results: Adjustment for travel time or distance made almost no difference to ethnic differences in screening rates. Adjustment for travel time reduced the excess risk for late‐stage diagnosis in Māori (the odds ratio (OR) reduced from 2.71 (95%CI 1.98–3.72) to 2.59 (1.88–3.56), a 7% decrease) and 33% in Pacific (the OR reduced from 1.39 (0.76–2.54) to 1.26 (0.68–2.33)) women. Adjustment for travel time reduced the excess risk for mortality by 3% in Māori (the hazard ratio (HR) reduced from 1.59 (1.21–2.08) to 1.57 (1.19–2.06)) and 13% in Pacific (the HR reduced from 1.92 (1.20–3.08) to 1.80 (1.11–2.91)) women. Similar findings were observed when using travel distance rather than travel time. Conclusions: Travel time and distance are only weakly associated with cervical cancer screening, stage at diagnosis and mortality in NZ. However, travel time may account for a small proportion of the ethnic differences in stage at diagnosis, and to a lesser extent mortality, particularly for Pacific women. Implications: The findings suggest that there may be ethnic variations in access to treatment or treatment quality, which may be related to travel time. Uterine cervical neoplasms ethnicity geographical variation inequalities New Zealand Public aspects of medicine Neil Pearce verfasserin aut Peter Day verfasserin aut Barry Borman verfasserin aut In Australian and New Zealand Journal of Public Health Elsevier, 2018 36(2012), 4, Seite 335-342 (DE-627)341908045 (DE-600)2070571-2 17536405 nnns volume:36 year:2012 number:4 pages:335-342 https://doi.org/10.1111/j.1753-6405.2012.00843.x kostenfrei https://doaj.org/article/f098bee056bc40769444bcf8738bfc1c kostenfrei https://doi.org/10.1111/j.1753-6405.2012.00843.x kostenfrei https://doaj.org/toc/1326-0200 Journal toc kostenfrei https://doaj.org/toc/1753-6405 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_184 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 36 2012 4 335-342 |
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Methods: The study involved 1,594 cervical cancer cases registered between 1994 and 2005. Travel time and distance to the GP and cancer centre were estimated using a Geographical Information System. Results: Adjustment for travel time or distance made almost no difference to ethnic differences in screening rates. Adjustment for travel time reduced the excess risk for late‐stage diagnosis in Māori (the odds ratio (OR) reduced from 2.71 (95%CI 1.98–3.72) to 2.59 (1.88–3.56), a 7% decrease) and 33% in Pacific (the OR reduced from 1.39 (0.76–2.54) to 1.26 (0.68–2.33)) women. Adjustment for travel time reduced the excess risk for mortality by 3% in Māori (the hazard ratio (HR) reduced from 1.59 (1.21–2.08) to 1.57 (1.19–2.06)) and 13% in Pacific (the HR reduced from 1.92 (1.20–3.08) to 1.80 (1.11–2.91)) women. Similar findings were observed when using travel distance rather than travel time. 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RA1-1270 Travel time and distance to health care only partially account for the ethnic inequalities in cervical cancer stage at diagnosis and mortality in New Zealand Uterine cervical neoplasms ethnicity geographical variation inequalities New Zealand |
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Travel time and distance to health care only partially account for the ethnic inequalities in cervical cancer stage at diagnosis and mortality in New Zealand |
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travel time and distance to health care only partially account for the ethnic inequalities in cervical cancer stage at diagnosis and mortality in new zealand |
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Travel time and distance to health care only partially account for the ethnic inequalities in cervical cancer stage at diagnosis and mortality in New Zealand |
abstract |
Abstract Objective: To investigate whether travel time or distance to the nearest general practitioner (GP) and/or cancer centre accounts for the ethnic differences in cervical cancer screening, stage at diagnosis and mortality in New Zealand (NZ). Methods: The study involved 1,594 cervical cancer cases registered between 1994 and 2005. Travel time and distance to the GP and cancer centre were estimated using a Geographical Information System. Results: Adjustment for travel time or distance made almost no difference to ethnic differences in screening rates. Adjustment for travel time reduced the excess risk for late‐stage diagnosis in Māori (the odds ratio (OR) reduced from 2.71 (95%CI 1.98–3.72) to 2.59 (1.88–3.56), a 7% decrease) and 33% in Pacific (the OR reduced from 1.39 (0.76–2.54) to 1.26 (0.68–2.33)) women. Adjustment for travel time reduced the excess risk for mortality by 3% in Māori (the hazard ratio (HR) reduced from 1.59 (1.21–2.08) to 1.57 (1.19–2.06)) and 13% in Pacific (the HR reduced from 1.92 (1.20–3.08) to 1.80 (1.11–2.91)) women. Similar findings were observed when using travel distance rather than travel time. Conclusions: Travel time and distance are only weakly associated with cervical cancer screening, stage at diagnosis and mortality in NZ. However, travel time may account for a small proportion of the ethnic differences in stage at diagnosis, and to a lesser extent mortality, particularly for Pacific women. Implications: The findings suggest that there may be ethnic variations in access to treatment or treatment quality, which may be related to travel time. |
abstractGer |
Abstract Objective: To investigate whether travel time or distance to the nearest general practitioner (GP) and/or cancer centre accounts for the ethnic differences in cervical cancer screening, stage at diagnosis and mortality in New Zealand (NZ). Methods: The study involved 1,594 cervical cancer cases registered between 1994 and 2005. Travel time and distance to the GP and cancer centre were estimated using a Geographical Information System. Results: Adjustment for travel time or distance made almost no difference to ethnic differences in screening rates. Adjustment for travel time reduced the excess risk for late‐stage diagnosis in Māori (the odds ratio (OR) reduced from 2.71 (95%CI 1.98–3.72) to 2.59 (1.88–3.56), a 7% decrease) and 33% in Pacific (the OR reduced from 1.39 (0.76–2.54) to 1.26 (0.68–2.33)) women. Adjustment for travel time reduced the excess risk for mortality by 3% in Māori (the hazard ratio (HR) reduced from 1.59 (1.21–2.08) to 1.57 (1.19–2.06)) and 13% in Pacific (the HR reduced from 1.92 (1.20–3.08) to 1.80 (1.11–2.91)) women. Similar findings were observed when using travel distance rather than travel time. Conclusions: Travel time and distance are only weakly associated with cervical cancer screening, stage at diagnosis and mortality in NZ. However, travel time may account for a small proportion of the ethnic differences in stage at diagnosis, and to a lesser extent mortality, particularly for Pacific women. Implications: The findings suggest that there may be ethnic variations in access to treatment or treatment quality, which may be related to travel time. |
abstract_unstemmed |
Abstract Objective: To investigate whether travel time or distance to the nearest general practitioner (GP) and/or cancer centre accounts for the ethnic differences in cervical cancer screening, stage at diagnosis and mortality in New Zealand (NZ). Methods: The study involved 1,594 cervical cancer cases registered between 1994 and 2005. Travel time and distance to the GP and cancer centre were estimated using a Geographical Information System. Results: Adjustment for travel time or distance made almost no difference to ethnic differences in screening rates. Adjustment for travel time reduced the excess risk for late‐stage diagnosis in Māori (the odds ratio (OR) reduced from 2.71 (95%CI 1.98–3.72) to 2.59 (1.88–3.56), a 7% decrease) and 33% in Pacific (the OR reduced from 1.39 (0.76–2.54) to 1.26 (0.68–2.33)) women. Adjustment for travel time reduced the excess risk for mortality by 3% in Māori (the hazard ratio (HR) reduced from 1.59 (1.21–2.08) to 1.57 (1.19–2.06)) and 13% in Pacific (the HR reduced from 1.92 (1.20–3.08) to 1.80 (1.11–2.91)) women. Similar findings were observed when using travel distance rather than travel time. Conclusions: Travel time and distance are only weakly associated with cervical cancer screening, stage at diagnosis and mortality in NZ. However, travel time may account for a small proportion of the ethnic differences in stage at diagnosis, and to a lesser extent mortality, particularly for Pacific women. Implications: The findings suggest that there may be ethnic variations in access to treatment or treatment quality, which may be related to travel time. |
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Travel time and distance to health care only partially account for the ethnic inequalities in cervical cancer stage at diagnosis and mortality in New Zealand |
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