Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Cancer Causes & Control
Published in: Cancer Causes & Control 9/2013

01-09-2013 | Original paper

Disparities in survival after female breast cancer diagnosis: a population-based study

Authors: Stacey L. Tannenbaum, Tulay Koru-Sengul, Feng Miao, Margaret M. Byrne

Published in: Cancer Causes & Control | Issue 9/2013

Login to get access

Abstract

Background

Despite advances in treatment and increased screening, female breast cancer survival is affected by race, ethnicity, and socioeconomic status (SES). The purpose of this study was to substantiate disparities in breast cancer mortality in a large and unique dataset containing 7 distinct racial groups, 31 comorbidities, demographic and clinical/pathological patient characteristics, and neighborhood poverty information.

Methods

Florida Cancer Data System registry (1996–2007) linked with the Agency for Health Care Administration and U.S. Census tract (n = 127,754) explored median survival and 1-, 3-, and 5-year survival rates by the Kaplan–Meier method. Log-rank tests compared survival curves by race/ethnicity/SES. Cox proportional hazards regression models were used to obtain unadjusted and adjusted hazard ratios (HR) and 95 % confidence intervals.

Results

Native Americans had the lowest median survival (7.4 years) and Asians had the highest (12.6 years). For the univariate analysis, worse survival was seen for blacks (HR = 1.44; p < 0.001) and better survival for Asians (HR = 0.71; p < 0.001), Asian Indians or Pakistanis (HR = 0.65; p = 0.013), and Hispanics (HR = 0.92; p < 0.001). Multivariate analysis demonstrated sustained survival detriment for blacks (HR = 1.28; p < 0.001) and improved survival for Hispanics (HR = 0.90; p = 0.001). For SES, there was an incremental improvement in survival for each higher SES category in all analyses (p < 0.001).

Conclusions

Utilizing a large enriched state cancer registry controlling for multiple demographic, clinical, and comorbidities, we fully explored survival disparities in female breast cancer and found certain aspects of race, ethnicity, and SES to remain significantly associated with breast cancer survival. More research is needed to uncover the source of these ongoing disparities.
Literature
1.
2.
3.
Siegel R, DeSantis C, Virgo K et al (2012) Cancer treatment and survivorship statistics. CA Cancer J Clin 62(4):220–241PubMedCrossRef
4.
5.
Maskarinec G, Sen C, Koga K, Conroy SM (2011) Ethnic differences in breast cancer survival: status and determinants. Women’s Health 7(6):677–687PubMed
6.
7.
8.
Chlebowski RT, Chen Z, Anderson GL et al (2005) Ethnicity and breast cancer: factors influencing differences in incidence and outcome. J Natl Cancer Inst 97(6):439–448PubMedCrossRef
9.
Grann V, Troxel AB, Zojwalla N, Hershman D, Glied SA, Jacobson JS (2006) Regional and racial disparities in breast cancer-specific mortality. Soc Sci Med 62(2):337–347PubMedCrossRef
10.
11.
O’Malley CD, Le GM, Glaser SL, Shema SJ, West DW (2003) Socioeconomic status and breast carcinoma survival in four racial/ethnic groups: a population-based study. Cancer 97(5):1303–1311PubMedCrossRef
12.
Clegg LX, Reichman ME, Miller BA et al (2009) Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: national longitudinal mortality study. Cancer Causes Control 20(4):417–435PubMedCrossRef
13.
Miller BA, Chu KC, Hankey BF, Ries LA (2008) Cancer incidence and mortality patterns among specific Asian and Pacific Islander populations in the U.S. Cancer Causes Control 19(3):227–256PubMedCrossRef
14.
Braun KL, Fong M, Gotay C, Pagano IS, Chong C (2005) Ethnicity and breast cancer in Hawaii: increased survival but continued disparity. Ethn Dis 15(3):453–460PubMed
15.
Leung GM, Thach TQ, Chan E et al (2005) Short-term, medium-term, long-term, and lifetime risks of developing and dying of breast carcinoma in a Westernized Chinese population: evidence from Hong Kong between 1976 and 2000. Cancer 103(3):501–508PubMedCrossRef
16.
Li CI, Malone KE, Daling JR (2003) Differences in breast cancer stage, treatment, and survival by race and ethnicity. Arch Intern Med 163(1):49–56PubMedCrossRef
17.
Gomez SL, Clarke CA, Shema SJ, Chang ET, Keegan TH, Glaser SL (2010) Disparities in breast cancer survival among Asian women by ethnicity and immigrant status: a population-based study. Am J Public Health 100(5):861–869PubMedCrossRef
18.
Redaniel MT, Laudico A, Mirasol-Lumague MR et al (2010) Breast cancer survival in different country settings: comparisons between a Filipino resident population, Filipino-Americans and Caucasians. Breast 19(2):109–114PubMedCrossRef
19.
Moran MS, Gonsalves L, Goss DM, Ma S (2011) Breast cancers in U.S. residing Indian-Pakistani versus non-Hispanic White women: comparative analysis of clinical-pathologic features, treatment, and survival. Breast Cancer Res Treat 128(2):543–551PubMedCrossRef
20.
Clegg LX, Li FP, Hankey BF, Chu K, Edwards BK (2002) Cancer survival among US whites and minorities: a SEER (Surveillance, Epidemiology, and End Results) Program population-based study. Arch Intern Med 162(17):1985–1993PubMedCrossRef
21.
Dasgupta P, Baade PD, Aitken JF, Turrell G (2012) Multilevel determinants of breast cancer survival: association with geographic remoteness and area-level socioeconomic disadvantage. Breast Cancer Res Treat 132(2):701–710PubMedCrossRef
22.
Du XL, Fang S, Meyer TE (2008) Impact of treatment and socioeconomic status on racial disparities in survival among older women with breast cancer. Am J Clin Oncol 31(2):125–132PubMedCrossRef
23.
Puliti D, Miccinesi G, Manneschi G et al (2012) Does an organised screening programme reduce the inequalities in breast cancer survival? Ann Oncol 23(2):319–323PubMedCrossRef
24.
Cross CK, Harris J, Recht A (2002) Race, socioeconomic status, and breast carcinoma in the U.S: what have we learned from clinical studies. Cancer 95(9):1988–1999PubMedCrossRef
25.
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(11):2844–2854PubMedCrossRef
26.
Gerend MA, Pai M (2008) Social determinants of Black-White disparities in breast cancer mortality: a review. Cancer Epidemiol Biomarkers Prev 17(11):2913–2923PubMedCrossRef
27.
Vona-Davis L, Rose DP (2009) The influence of socioeconomic disparities on breast cancer tumor biology and prognosis: a review. J Womens Health 18(6):883–893CrossRef
28.
Krieger N (1992) Overcoming the absence of socioeconomic data in medical records: validation and application of a census-based methodology. Am J Public Health 82(5):703–710PubMedCrossRef
29.
Li CI, Malone KE, Daling JR (2003) Differences in breast cancer stage, treatment, and survival by race and ethnicity. Arch Intern Med 163:49–56PubMedCrossRef
30.
Deshpande AD, Jeffe DB, Gnerlich J, Iqbal AZ, Thummalakunta A, Margenthaler JA (2009) Racial disparities in breast cancer survival: an analysis by age and stage. J Surg Res 153:105–113PubMedCrossRef
Metadata
Title
Disparities in survival after female breast cancer diagnosis: a population-based study
Authors
Stacey L. Tannenbaum
Tulay Koru-Sengul
Feng Miao
Margaret M. Byrne
Publication date
01-09-2013
Publisher
Springer Netherlands
Published in
Cancer Causes & Control / Issue 9/2013
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-013-0246-5

Other articles of this Issue 9/2013

Cancer Causes & Control 9/2013 Go to the issue

Original paper

Exposures to multiple pesticides and the risk of Hodgkin lymphoma in Canadian men

Original paper

A large prospective study of risk factors for adenocarcinomas and malignant carcinoid tumors of the small intestine

Original paper

Birth size and survival in breast cancer patients from the Uppsala Birth Cohort Study

Brief report

Prenatal DES exposure in relation to breast size

Original paper

Pregnancy-related characteristics and breast cancer risk

Original paper

Do reproductive and hormonal risk factors for breast cancer associate with attendance at mammography screening?
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
Image Credits