Is breast cancer survival correlated with indicators of the right to health? An interdisciplinary study in 58 countries

Background
Women with breast cancer have different chances of surviving their disease, depending on where they live. When breast cancer is diagnosed and treated early, the chances of longer-term survival improve. Inequalities in survival are deemed unfair, because high survival for breast cancer can be achieved. We enquired whether adoption of a human rights-based approach to breast cancer care and management is correlated with breast cancer survival.
Method
We reviewed the law literature on key concepts of the human right to health and performed a scoping review of the public health literature. We then used a Delphi technique to identify indicators of the right to health, and collected information for 17 indicators for which consensus was achieved. We then examined correlations with five-year net survival for women diagnosed with breast cancer during 2010–14 in up to 58 OECD countries. We used survival estimates from the CONCORD programme for the global surveillance of cancer survival.
Results
Higher survival was correlated with the availability of radiotherapy equipment, financial availability of morphine, morphine consumption, the number of nurses and midwives, and the proportion of eligible women screened for breast cancer in the previous two years. Lower survival was correlated with the proportion of women diagnosed at an advanced stage, out-of-pocket expenditure, and legal recognition of the right to health.
Conclusion
The findings show that some right-to-health components of health systems are correlated with higher survival for breast cancer, suggesting that adoption of a human rights-based approach to breast cancer care and management may help improve survival and reduce inequalities.