Top

Published in:

01-02-2009 | Brief Report

Increased racial differences on breast cancer care and survival in America: historical evidence consistent with a health insurance hypothesis, 1975–2001

Authors: Kevin M. Gorey, Isaac N. Luginaah, Kendra L. Schwartz, Karen Y. Fung, Madhan Balagurusamy, Emma Bartfay, Frances C. Wright, Uzoamaka Anucha, Renee R. Parsons

Published in: Breast Cancer Research and Treatment | Issue 3/2009

Abstract

Purpose This study examined whether race/ethnicity had differential effects on breast cancer care and survival across age strata and cohorts within stages of disease. Methods The Detroit Cancer Registry provided 25,997 breast cancer cases. African American and non-Hispanic white, older Medicare-eligible and younger non-eligible women were compared. Successive historical cohorts (1975–1980 and 1990–1995) were, respectively, followed until 1986 and 2001. Results African American disadvantages on survival and treatments increased significantly, particularly among younger women who were much more likely to be uninsured. Within node positive disease all treatment disadvantages among younger African American women disappeared with socioeconomic adjustment. Conclusions Growth of this racial divide implicates social, rather than biological, forces. Its elimination will require high quality health care for all.

Bach PB, Schrag D, Brawley OW et al (2002) Survival of blacks and whites after a cancer diagnosis. JAMA 287:2106–2113PubMedCrossRef

Newman LA, Mason J, Cote D et al (2002) African-American ethnicity, socioeconomic status, and breast cancer survival: a meta-analysis of 14 studies involving over 10,000 African-American and 40,000 white American patients with carcinoma of the breast. Cancer 94:2844–2854PubMedCrossRef

Parsons RR, Gorey KM, Anucha U et al (2004) Institutionalized racism and classism in health care: meta-analytic evidence of their existence in America, but not in Canada. Paper presented at the 132nd annual meeting of the American Public Health Association, Washington, DC, November, 2004

Simon MS, Banerjee M, Crossley-May H et al (2006) Racial differences in breast cancer survival in the Detroit metropolitan area. Breast Cancer Res Treat 97:149–155PubMedCrossRef

Schwartz KL, Crossley-May H, Vigneau FD et al (2003) Race, socioeconomic status and stage at diagnosis for five common malignancies. Cancer Causes Control 14:761–766PubMedCrossRef

Simon MS, Severson RK (1997) Racial differences in breast cancer survival: the interaction of socioeconomic status and tumor biology. Am J Obstet Gynecol 176:S233–S239PubMedCrossRef

Ries LAG, Eisner MP, Kosary CL et al (eds) (2004) SEER cancer statistics review, 1975–2001. National Cancer Institute, Bethesda

Schulz AJ, Williams DR, Israel BA et al (2002) Racial and spatial relations as fundamental determinants of health in Detroit. Milbank Q 80:677–707PubMedCrossRef

Jargowsky PA (1997) Poverty and place: ghettos, barrios, and the American city. Russell Sage Foundation, New York

10.

Crowe JP Jr, Patrick RJ, Rybicki LA et al (2005) Race is a fundamental prognostic indicator for 2325 northeastern Ohio women with infiltrating breast cancer. Breast J 11:124–128PubMedCrossRef

11.

Aziz H, Hussain F, Sohn C et al (1999) Early onset of breast carcinoma in African American women with poor prognostic factors. Am J Clin Oncol 22:436–440PubMedCrossRef

12.

Merkin SS, Stevenson L, Powe N (2002) Geographic socioeconomic status, race, and advanced-stage breast cancer in New York City. Am J Public Health 92:64–70PubMedCrossRef

13.

Miller BA, Hankey BF, Thomas TL (2002) Impact of sociodemographic factors, hormone receptor status, and tumor grade on ethnic differences in tumor stage and size for breast cancer in US women. Am J Epidemiol 155:534–545PubMedCrossRef

14.

Eley JW, Hill HA, Chen VW et al (1994) Racial differences in survival from breast cancer. JAMA 272:947–954PubMedCrossRef

15.

Krieger N, van den Eeden SK, Zava D et al (1997) Race/ethnicity, social class, and prevalence of breast cancer prognostic biomarkers: a study of white, black, and Asian women in the San Francisco bay area. Ethn Dis 7:137–149PubMed

16.

Gordon NH, Crowe JP, Brumberg DJ et al (1992) Socioeconomic factors and race in breast cancer recurrence and survival. Am J Epidemiol 135:609–618PubMed

17.

Himmelstein DU, Woolhandler S, Hellander I et al (1999) Quality of care in investor-owned vs not-for-profit HMOs. JAMA 282:159–163PubMedCrossRef

18.

Taylor AK, Beauregard KM, Vistnes JP (1995) Who belongs to HMOs: a comparison of fee-for-service versus HMO enrollees. Med Care Res Rev 52:389–408PubMedCrossRef

19.

Hadley JP, Langwell K (1991) Managed care in the United States: promises, evidence to date and future directions. Health Policy 19:91–118PubMedCrossRef

20.

Nelson DE, Bolen J, Wells HE et al (2004) State trends in uninsured among individuals aged 18 to 64 years: United States, 1992–2001. Am J Public Health 94:1992–1997PubMedCrossRef

21.

Institute of Medicine (2004) Insuring America’s health: principles and recommendations. National Academies Press, Washington

22.

Carrasquillo O, Himmelstein DU, Wollhandler S, Bor DH (1999) Going bare: trends in health insurance coverage, 1989 through 1996. Am J Public Health 89:36–42PubMed

23.

Zuvekas SH, Weinick RM (1999) Changes in access to care, 1977–1996: the role of health insurance. Health Serv Res 34(1 Pt 2):271–279PubMed

24.

Brown ER (1989) Access to health insurance in the United States. Med Care Rev 46:349–385PubMedCrossRef

25.

Gorey KM (2006) Regarding “associations between socioeconomic status and breast cancer survival.” Ann Epidemiol 16:789–791PubMedCrossRef

26.

Gorey KM, Kliewer E, Holowaty EJ et al (2003) An international comparison of breast cancer survival: Winnipeg, Manitoba and Des Moines, Iowa metropolitan areas. Ann Epidemiol 13:32–41PubMedCrossRef

27.

Gorey KM, Holowaty EJ, Fehringer G et al (2000) An international comparison of cancer survival: Toronto, Ontario and Honolulu, Hawaii metropolitan areas. Am J Public Health 90:1866–1872PubMedCrossRef

28.

Gorey KM, Holowaty EJ, Fehringer G et al (1997) An international comparison of cancer survival: Toronto, Ontario and Detroit, Michigan metropolitan areas. Am J Public Health 87:1156–1163PubMedCrossRef

29.

McDavid K, Tucker TC, Sloggett A et al (2003) Cancer survival in Kentucky and health insurance coverage. Arch Intern Med 163:2135–2144PubMedCrossRef

30.

Bradley CJ, Given CW, Roberts C (2003) Correlates of late stage breast cancer and death in a Medicaid-insured population. J Health Care Poor Underserved 14:503–515PubMed

31.

Bradley CJ, Given CW, Roberts C (2003) Late stage cancers in a Medicaid-insured population. Med Care 41:722–728PubMedCrossRef

32.

Bradley CJ, Given CW, Roberts C (2002) Race, socioeconomic status, and breast cancer treatment and survival. J Natl Cancer Inst 94:490–496PubMed

33.

Lee-Feldstein A, Feldstein PJ, Buchmueller T et al (2001) Breast cancer outcomes among older women: HMO, fee-for-service, and delivery system comparisons. J Gen Intern Med 16:189–199PubMedCrossRef

34.

Gorey KM (1999) What is wrong with the U.S. heath care system? It does not effectively exist for one of every five Americans. Milbank Q 77:401–407PubMedCrossRef

35.

Ni H, Cohen R (2007) U.S. Department of Health and Human Services. Trends in health insurance coverage by race/ethnicity among persons under 65 years of age: United States, 1997–2001. National Center for Health Statistics (Health E-Stats), Hyattsville

36.

Du W, Simon MS (2005) Racial disparities in treatment and survival of women with stage I–III breast cancer at a large academic medical center in metropolitan Detroit. Breast Cancer Res Treat 91:243–248PubMedCrossRef

37.

Maskarinec G, Pagano IS, Yamashiro G et al (2003) Influences of ethnicity, treatment, and comorbidity on breast cancer survival in Hawaii. J Clin Epidemiol 56:678–685PubMedCrossRef

38.

Newman LA, Kuerer HM, Hunt KK et al (2000) Response to induction chemotherapy in black and white patients with locally advanced breast cancer. Breast J 6:242–246PubMedCrossRef

39.

Velanovich V, Yood MU, Bawle U et al (1999) Racial differences in the presentation and surgical management of breast cancer. Surgery 125:375–379PubMed

40.

Wojcik BE, Spinks MK, Optenberg SA (1998) Breast carcinoma survival analysis for African American and white women in an equal-access health care system. Cancer 82:1310–1318PubMedCrossRef

41.

Dignam JJ, Redmond CK, Fisher B et al (1997) Prognosis among African-American women and white women with lymph node negative breast carcinoma: findings from two randomized clinical trials of the national surgical adjuvant breast and bowel project (NSABP). Cancer 80:80–90PubMedCrossRef

42.

Escarce JJ, McGuire TG (2004) Changes in racial differences in use of medical procedures and diagnostic tests among elderly persons: 1986–1997. Am J Public Health 94:1795–1799PubMedCrossRef

43.

Chu KC, Tarone RE, Brawley OW (1999) Breast cancer trends of black women compared with white women. Arch Fam Med 8:521–528PubMedCrossRef

44.

Wagener DK, Schatzkin A (1994) Temporal trends in the socioeconomic gradient for breast cancer mortality among US women. Am J Public Health 84:1003–1006PubMedCrossRef

45.

Swanson GM, Ragheb NR, Lin CS et al (1993) Breast cancer among black and white women in the 1980s: changing patterns in the United States by race, age, and extent of disease. Cancer 72:788–798PubMedCrossRef

46.

Swanson GM, Satariano ER, Satariano WA et al (1990) Racial differences in the early detection of breast cancer in metropolitan Detroit. Cancer 66:1297–1301PubMedCrossRef

47.

Hosmer D, Lemeshow S (1989) Applied logistic regression. Wiley, NY

48.

DeNavas-Walt C, Proctor BD, Lee CH (2006) U.S. Census Bureau. Income, poverty, and health insurance coverage in the United States, 2005 (current population reports, P60-231). U.S. Government Printing Office, Washington

49.

Krieger N, Chen JT, Waterman PD et al (2003) Race/ethnicity, gender, and monitoring socioeconomic gradients in health: a comparison of area-based socioeconomic measures—the public health disparities geocoding project. Am J Public Health 93:1655–1671PubMedCrossRef

50.

Krieger N, Chen JT, Waterman PD et al (2002) Geocoding and monitoring of US socioeconomic inequalities in mortality and cancer incidence: does the choice of area-based measure and geographic level matter? The public health disparities geocoding project. Am J Epidemiol 156:471–482PubMedCrossRef

51.

Census of the Population and Housing, 1990 (Michigan) (1992) [summary tape file on CD-ROM]. US Bureau of the Census, Data User Services Division, Washington

52.

Census of the Population and Housing, 1980 (Michigan) (1982) [summary tape file on CD-ROM]. US Bureau of the Census, Data User Services Division, Washington

53.

Du XL, Meyer TE, Franzini L (2007) Meta-analysis of racial disparities in survival in association with socioeconomic status among men and women with colon cancer. Cancer 109:2161–2170PubMedCrossRef

54.

Robbins AS, Yin D, Parikh-Patel A (2007) Differences in prognostic factors and survival among white men and black men with prostate cancer, California, 1995–2004. Am J Epidemiol 166:71–78PubMedCrossRef

55.

Bickell NA, LePar F, Wang JJ et al (2007) Lost opportunities: physicians’ reasons and disparities in breast cancer treatment. J Clin Oncol 25:2516–2521PubMedCrossRef

56.

Foley KL, Kimmick G, Camacho F et al (2007) Survival disadvantage among Medicaid-insured breast cancer patients treated with breast conserving surgery without radiation therapy. Breast Cancer Res Treat 101:207–214PubMedCrossRef

57.

Griggs JJ, Culakova E, Sorbero ME et al (2007) Social and racial differences in selection of breast cancer adjuvant chemotherapy regimens. J Clin Oncol 25:2522–2527PubMedCrossRef

58.

Richardson LC, Tian L, Voti L et al (2006) The roles of teaching hospitals, insurance status, and race/ethnicity in receipt of adjuvant therapy for regional-stage breast cancer in Florida. Am J Public Health 96:160–166PubMedCrossRef

59.

Voti L, Richardson LC, Reiss I et al (2006) The effect of race/ethnicity and insurance in the administration of standard therapy for local breast cancer in Florida. Breast Cancer Res Treat 95:89–95PubMedCrossRef

60.

Roetzheim RG, Gonzalez EC, Ferrante JM et al (2000) Effects of health insurance and race on breast carcinoma treatments and outcomes. Cancer 89:2202–2213PubMedCrossRef

61.

Lee-Feldstein A, Feldstein PJ, Buchmueller T et al (2000) The relationship of HMOs, health insurance, and delivery systems to breast cancer outcomes. Med Care 38:705–718PubMedCrossRef

62.

Institute of Medicine (1999) In: Hewitt M, Simone JV (eds) Ensuring quality cancer care. National Academy Press, Washington

63.

Brown BW, Brauner C, Minnotte MC (1993) Noncancer deaths in white adult cancer patients. J Natl Cancer Inst 85:979–987PubMedCrossRef

64.

Lund MJ, Brawley OP, Ward KC et al (in press) Parity and disparity in first course treatment of invasive breast cancer. Breast Cancer Res Treat

Title: Increased racial differences on breast cancer care and survival in America: historical evidence consistent with a health insurance hypothesis, 1975–2001
Authors: Kevin M. Gorey
Isaac N. Luginaah
Kendra L. Schwartz
Karen Y. Fung
Madhan Balagurusamy
Emma Bartfay
Frances C. Wright
Uzoamaka Anucha
Renee R. Parsons
Publication date: 01-02-2009
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 3/2009
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-008-9960-1

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2009

HER2 status predicts the presence of circulating tumor cells in patients with operable breast cancer

Models for predicting BRCA1 and BRCA2 mutations in Han Chinese familial breast and/or ovarian cancer patients

Estrogen suppression in premenopausal women following 8 weeks of treatment with exemestane and triptorelin versus triptorelin alone

Peroxisome proliferator-activated receptor gamma activates fas ligand gene promoter inducing apoptosis in human breast cancer cells

Surveying germline genomic landscape of breast cancer

Tumor-specific RNAi targeting eIF4E suppresses tumor growth, induces apoptosis and enhances cisplatin cytotoxicity in human breast carcinoma cells

Keynote webinar | Spotlight on antibody–drug conjugates in cancer