TITLE:
Breast Cancer Survival Rates in Costa Rican Social Security Fund Patients: A 5-Year Analysis
AUTHORS:
Amada Aparicio, Percy Guzman, Esmeralda Ramirez-Pena, Melvin Morera Salas, Michael Halpern
KEYWORDS:
Breast Cancer, Survival, Risk Factors, Treatment
JOURNAL NAME:
Open Journal of Social Sciences,
Vol.11 No.9,
September
18,
2023
ABSTRACT: Background: Breast cancer is a significant cause of mortality among women worldwide.
While there has been increasing focus on breast cancer screening in countries
of Central American, limited recent information is available providing national
survival rates. This study aimed to determine the 5-year survival rate for
women with breast cancer who received treatment through the Costa Rican Caja
Costarricense del Seguro Social (CCSS) between 2008 and 2012. Methods: A
retrospective cohort study was conducted of women with breast cancer who
received treatment through the CCSS between 2008 and 2012. The Kaplan-Meier
(KP) method was used to calculate survival rates, and univariate and
multivariate Cox regression analyses were conducted to identify factors
associated with survival. Results: The KP method showed a gradual
decline in survival over time, declining from 94.4% at 12 months to 76.3% at 5
years. The 5-year survival rates were highest in early-stage (stage I and IIA)
and lowest in stage IV; five-year mortality rate among women diagnosed with
stage IIIB cancer was four times higher than for those with stage IIB cancer
and half that of women diagnosed with metastatic disease. Patients who
underwent conservative or radical surgery had decreased risks of mortality compared to those who did not receive surgery.
Multivariate analysis identified advanced stage, older age, multifocal
tumors, poorly differentiated tumors, triple-negative tumors, and the absence
of surgery as significant risk factors for mortality. Conclusion: The 5-year
survival rate for women with breast cancer who received treatment through the
CCSS between 2008 and 2012 is encouraging,
but improvement is needed in early diagnosis and treatment, particularly
for women with advanced stages of breast cancer. These findings highlight the
need for continued efforts to improve breast cancer detection and treatment in
Costa Rica.