Abstract 47: Survival of Breast Cancer in Women Treated Under Mexico's Seguro Popular

Purpose: To determine 5-year survival for breast cancer among uninsured women treated under Mexico9s Seguro Popular landmark health reform according to clinical stage and identify factors associated to survival. Methods: We conducted a retrospective cohort study with data obtained from national reimbursement claims of patients treated under Seguro Popular from January 2007 to December 2016. Reimbursement data was cross-linked with a national mortality registry. We used the Kaplan-Meier method to estimate overall survival according to different variables and stratified them by clinical stage as early (I-IIA), locally advanced (IIB-IIIC), and metastatic (IV). We explored the relation between age, hospital patient volume, hospital infrastructure, and mortality. Hazard ratios and 95% confidence intervals (95%CI) were estimated, using the Cox proportional hazards model to adjust for clinical stage. Results: A total of 57,175 patients with breast cancer were analyzed. The mean age was 43.4 (SD 12.4). Most patients had locally advanced disease at diagnosis (55.1%, n=31,559) and 9.5% (n=5,435) had metastatic disease. The distribution of clinical stage did not appear to change over time (11% in 2007 vs. 13% in 2015 for metastatic disease). Five-year survival was 88.9% (CI95% 88.3-89.5) for early-stage disease, 69.6% (CI95% 69-70.2) for locally advanced cancer, and 36.9% (CI95% 35.4-38.5) for metastatic disease. These survival estimates did not change over time. After adjustment for clinical stage, age Conclusions: While Seguro Popular provided access to treatment for breast cancer, a high proportion of women were treated at advanced stages and clinical stage at diagnosis and survival did not appear to change over a decade. Future programs should prioritize early detection and strengthen quality of care. Citation Format: Antonio Bandala-Jacques, Rodrigo Huerta-Gutierrez, Salvador Zamora-Munoz, Paula Cabrera, Alejandro Mohar, Martin Lajous. Survival of Breast Cancer in Women Treated Under Mexico9s Seguro Popular [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 47.