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Purpose <p>Socioeconomic inequalities in breast cancer survival persist in the UK. Area-based deprivation measures may underestimate socioeconomic effects by assigning average deprivation levels to all area inhabitants. This study investigated associations between house value (individual-level) and area-based deprivation with breast cancer outcomes in Northern Ireland.</p> Methods <p>Women diagnosed with breast cancer from 2011 to 2021 were identified using the Northern Ireland Cancer Registry. House value was determined from Valuation and Lands Agency property valuation data, and area-based deprivation from the Northern Ireland Multiple Deprivation Measure. The primary outcome was breast cancer-specific mortality. Secondary outcomes were stage at diagnosis and all-cause mortality. Cox regression models calculated adjusted hazard ratios (HR) and 95% confidence intervals (95% CIs) for mortality by house value category and deprivation, adjusting for confounders.</p> Results <p>Among 12,766 women with breast cancer, women in the lowest versus highest house value category had a 60% increase in mortality (adjusted HR = 1.60 95% CI 1.34, 1.92; per 20 percentile decrease adjusted HR = 1.12 95% CI 1.08, 1.16) and were more likely diagnosed with stage 4 disease (7.5% versus 4.1%; <i>P</i> &lt; 0.001). Women living in the most versus least deprived areas had a 26% increase in mortality (adjusted HR = 1.26 95% CI 1.08, 1.47; per 20 percentile decrease adjusted HR = 1.05 95% CI 1.01, 1.08) but had no difference in stage 4 disease (5.9% vs. 5.0%; <i>P</i> = 0.157).</p> Conclusion <p>Individual-level house value demonstrated stronger associations with breast cancer outcomes than area-level deprivation, suggesting it may serve as a more sensitive indicator for monitoring health inequalities in cancer.</p>

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House value as an individual socioeconomic indicator for breast cancer survival and late-stage diagnosis: a population-based cohort study from Northern Ireland

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月21日

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  • Sarah M. Baxter,
  • Charlene M. McShane,
  • Stuart A. McIntosh,
  • Damien Bennett,
  • Meenakshi Sharma,
  • Lynne Lohfeld,
  • Daniel R. S. Middleton,
  • Gerard Savage,
  • Deirdre Fitzpatrick,
  • Ann McBrien,
  • David McCallion,
  • Anna Gavin,
  • Chris R. Cardwell

摘要

Purpose

Socioeconomic inequalities in breast cancer survival persist in the UK. Area-based deprivation measures may underestimate socioeconomic effects by assigning average deprivation levels to all area inhabitants. This study investigated associations between house value (individual-level) and area-based deprivation with breast cancer outcomes in Northern Ireland.

Methods

Women diagnosed with breast cancer from 2011 to 2021 were identified using the Northern Ireland Cancer Registry. House value was determined from Valuation and Lands Agency property valuation data, and area-based deprivation from the Northern Ireland Multiple Deprivation Measure. The primary outcome was breast cancer-specific mortality. Secondary outcomes were stage at diagnosis and all-cause mortality. Cox regression models calculated adjusted hazard ratios (HR) and 95% confidence intervals (95% CIs) for mortality by house value category and deprivation, adjusting for confounders.

Results

Among 12,766 women with breast cancer, women in the lowest versus highest house value category had a 60% increase in mortality (adjusted HR = 1.60 95% CI 1.34, 1.92; per 20 percentile decrease adjusted HR = 1.12 95% CI 1.08, 1.16) and were more likely diagnosed with stage 4 disease (7.5% versus 4.1%; P < 0.001). Women living in the most versus least deprived areas had a 26% increase in mortality (adjusted HR = 1.26 95% CI 1.08, 1.47; per 20 percentile decrease adjusted HR = 1.05 95% CI 1.01, 1.08) but had no difference in stage 4 disease (5.9% vs. 5.0%; P = 0.157).

Conclusion

Individual-level house value demonstrated stronger associations with breast cancer outcomes than area-level deprivation, suggesting it may serve as a more sensitive indicator for monitoring health inequalities in cancer.