Abstract
BackgroundThe healthcare system (HCS) improved in Tibet Autonomous Region (TAR), China. The present study aimed to investigate whether these improvements might alter the clinicopathological characteristics of a Tibetan female with breast cancer (BC) in TAR.MethodsThis was a single-center cross-sectional study conducted at TAR People’s Hospital. All Tibetan adult women were treated for BC in this hospital between January 1, 1973 and December 31, 2015. The inclusion criteria were as follows: (1) Tibetan adult woman living in Tibet; (2) Histopathology or cytopathology or both confirming primary BC; (3) All the treatments were finished in this hospital. χ2 test and logistic regression were applied, using age group and census register as the two covariates.ResultsA total of 273 patients with BC were included in the final analysis. Of these, 14 patients were in the free HCS, 183 patients had medical insurance combined with a new rural cooperative HCS, and 76 were in a rural and urban integration HCS. Currently, a rural and urban integration HCS is an improved system. Consequently, an increase in the proportion patients in the T1–3 stage was observed (0.198; 0.046 to 0.852) between the rural and urban integration HCS and free HCS. The proportion of patients in early (I + II) stage cancer (0.110; 0.019–0.633) also increased between these two HCSs.ConclusionThis was the first report about Tibetan women with BC in Tibet. Some clinicopathological characteristics at the presentation of Tibetan women with BC may improve during different HCSs. The cancer awareness, early detection, and the overall management in patients with advanced stage BC might improve the prognosis of BC in the rural and urban integration HCS.
Highlights
The healthcare system (HCS) improved in Tibet Autonomous Region (TAR), China
The first case of Tibetan female patient with breast cancer (BC) was admitted in 1973; she originated from Lhasa
The cohort consisted of 14 Tibetan females with BC in free HCS, 183 in the Medical insurance (MI) combined with a new rural cooperative HCS, and 76 in a rural and urban integration HCS
Summary
The healthcare system (HCS) improved in Tibet Autonomous Region (TAR), China. The present study aimed to investigate whether these improvements might alter the clinicopathological characteristics of a Tibetan female with breast cancer (BC) in TAR. Tibet Autonomous Region (TAR), known as “the roof of the world” with an average altitude above 4000 m, lies in southwest frontier of China under a relatively restricted level of HCS in China [16]. We hypothesized that the clinicopathological characteristics of the Tibetan female with BC might be aggressive as that in the other regions with fewer HCSs [12]. We described, for the first time, the clinicopathological characteristics at the presentation of Tibetan female with BC, and identified the influence of different HCSs on these characteristics
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