Journal Article

Disparities in race/ethnicity and socioeconomic status: risk of mortality of breast cancer patients in the California Cancer Registry, 2000–2010

Parise, Carol A, Caggiano, Vincent

2013

Overview

Background Racial disparities in breast cancer survival have been well documented. This study examines the association of race/ethnicity and socioeconomic status (SES) on breast cancer-specific mortality in a large population of women with invasive breast cancer. Methods We identified 179,143 cases of stages 1–3 first primary female invasive breast cancer from the California Cancer Registry from January, 2000 through December, 2010. Cox regression, adjusted for age, year of diagnosis, grade, and ER/PR/HER2 subtype, was used to assess the association of race/ethnicity on breast cancer-specific mortality within strata of stage and SES. Hazard ratios (HR) and 95% confidence intervals were reported. Results Stage 1: There was no increased risk of mortality for any race/ethnicity when compared with whites within all SES strata. Stage 2: Hispanics (HR = 0.85; 0.75, 0.97) in the lowest SES category had a reduced risk of mortality.. Blacks had the same risk of mortality as whites in the lowest SES category but an increased risk of mortality in the intermediate (HR = 1.66; 1.34, 2.06) and highest (HR = 1.41; 1.15, 1.73) SES categories. Stage 3: Hispanics (HR = 0.74; 0.64, 0.85) and APIs (HR = 0.64; 0.50, 0.82) in the lowest SES category had a reduced risk while blacks had similar mortality as whites. Blacks had an increased risk of mortality in the intermediate (HR = 1.52; 1.20, 1.92) and highest (HR = 1.53; 1.22, 1.92) SES categories. Conclusions When analysis of breast cancer-specific mortality is adjusted for age and year of diagnosis, ER/PR/HER2 subtype, and tumor grade and cases compared within stage and SES strata, much of the black/white disparity disappears. SES plays a prominent role in breast cancer-specific mortality but it does not fully explain the racial/ethnic disparities and continued research in genetic, societal, and lifestyle factors is warranted.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V
• Subject: Adult / Age / Aged / Aged, 80 and over / Biomedical and Life Sciences / Biomedicine / Breast cancer / Breast Neoplasms - epidemiology / Breast Neoplasms - mortality / Breast Neoplasms - pathology / California - epidemiology / California - ethnology / Cancer / Cancer patients / Cancer Research / Censuses / Economic aspects / Epidemiology / Ethnicity / Female / Health aspects / Health Promotion and Disease Prevention / Health Status Disparities / Hispanic people / Hospitals / Humans / Incidence / Medical prognosis / Medical records / Medicine/Public Health / Middle Aged / Missing data / Mortality / Native North Americans / Neoplasm Grading / Neoplasm Invasiveness / Neoplasm Staging / Oncology / Oncology, Experimental / Pacific Islander people / prevention and public health / Proportional Hazards Models / Public health / Race / Receptor, ErbB-2 - metabolism / Receptors, Estrogen - metabolism / Receptors, Progesterone - metabolism / Registries / Research Article / Social aspects / Social Class / Social classes / Socioeconomic factors / Surgical Oncology / Womens health / Young Adult