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Aging Clinical and Experimental Research

, Volume 30, Issue 2, pp 139–144 | Cite as

Ageism and surgical treatment of breast cancer in Italian hospitals

  • Mirko Di Rosa
  • Carlos Chiatti
  • Joseph M. Rimland
  • Marina Capasso
  • Valerio M. Scandali
  • Emilia Prospero
  • Andrea Corsonello
  • Fabrizia Lattanzio
Original Article

Abstract

Aim

To determine if age is a factor influencing the type of breast cancer surgery (radical versus conservative) in Italy and to investigate the regional differences in breast cancer surgery clinical practice.

Methods

Retrospective study is based on national hospital discharge records. The study draws on routinely collected data from hospital discharge records in Italy in 2010. The following exclusion criteria were applied: day hospital stays, patients younger than 17 years, males, patients without an ICD-9CM code indicating breast cancer and breast surgery, and repeated hospital admission of the same patient. Overall, 49,058 patient records were selected for the analysis.

Results

The proportion of conservative breast cancer operations was 70.9%. A greater number of women younger than 70 had undergone a breast-conserving operation compared to older women. There were regional variations ranging from a minimum in Basilicata to a maximum in Val d’Aosta. Multivariate analysis revealed that older patients with lower clinical severity were more likely to have undergone a radical operation than younger women. In addition, radical surgery was approximately twice as likely to occur in a private hospital that performed at least 50 breast cancer operations annually than in a public hospital that performed <50 breast surgeries.

Conclusion

Notwithstanding increases in life expectancy and the lack of clinical evidence to support the use of age as a surrogate for co-morbid conditions and frailty, our data on breast cancer operations in Italy are consistent with the hypothesis suggesting the persistence of ageistic practice in the healthcare system.

Keywords

Ageism Breast cancer surgery Health inequalities 

Notes

Acknowledgements

We want to thank the “Agenzia Nazionale per i Servizi Sanitari Regionali” for providing the national database on Hospital Discharge Forms.

Compliance with ethical standards

Conflict of interest

No conflict of interest has been declared by the authors.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Mirko Di Rosa
    • 1
  • Carlos Chiatti
    • 1
  • Joseph M. Rimland
    • 1
  • Marina Capasso
    • 2
  • Valerio M. Scandali
    • 3
  • Emilia Prospero
    • 3
  • Andrea Corsonello
    • 4
  • Fabrizia Lattanzio
    • 1
  1. 1.Scientific DirectionNational Institute of Health and Science on Aging-I.N.R.C.A.AnconaItaly
  2. 2.Local Health UnitLatinaItaly
  3. 3.Section of Hygiene and Public HealthPolytechnic University of the Marche RegionAnconaItaly
  4. 4.Unit of Geriatric PharmacoepidemiologyNational Institute of Health and Science on Aging-I.N.R.C.A.CosenzaItaly

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