Irish women from deprived areas are one-third more likely to die of breast cancer than women from wealthier areas, a study of survival rates from the disease shows.
Researchers say the disparity is due to a complex range of factors, about half of which are explainable.
Women from deprived areas are more likely to be diagnosed at advanced stages of cancer and to present with more aggressive tumours, and were less likely to present through screening programmes.
There were also more likely to have another serious medical condition and to be smokers.
The study, by a team from the National Cancer Registry in Cork, said smoking appeared to be only a minor contributor to survival disparities, though detailed information on tobacco consumption was lacking.
The disparity in survival rates related to deprivation was most pronounced in the greater Dublin area, where screening programmes were first introduced and where the major teaching hospitals are located.
The size of the disparity is similar to that found in studies conducted in other countries, even those with a more equitable access to treatment than Ireland’s two-tier health system.
The incidence of breast cancer is rising, with about 3,000 new cases each year. The mortality rate is falling, due to earlier detection and better treatments.
The study, based on the records of over 21,000 women with breast cancer between 1999 and 2008 and published in the journal PLOS One, says the policy implications are clear.
Survival disparities need to be reduced by targeting areas of known disparities, and encouraging greater awareness of the importance of early detection, treatment compliance, and lifestyle factors.
The Irish Cancer Society said the Government needed to act on the “worrying breast cancer gap” between deprived and wealthier areas.
“Despite the strides made in diagnosis, treatment and improvements in outcomes in the last few decades, Ireland has become a very unequal society when it comes to health problems, particularly cancer and access to healthcare,” said Kathleen O’Meara, head of advocacy and communications.
