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Disparities in breast cancer characteristics and outcomes by race/ethnicity

TitleDisparities in breast cancer characteristics and outcomes by race/ethnicity
Publication TypeJournal Article
Year of Publication2011
AuthorsOoi, SL, Martinez, ME, Li, CI
JournalBreast Cancer Res TreatBreast Cancer Res Treat
Date PublishedJun
ISBN Number1573-7217 (Electronic)<br/>0167-6806 (Linking)
Accession Number21076864
KeywordsAdult, Aged, Breast Neoplasms/ epidemiology/therapy, Female, Health Status Disparities, Healthcare Disparities, Humans, Middle Aged, Neoplasm Staging, Receptors, Estrogen, Receptors, Progesterone, SEER Program, Treatment Outcome

Disparities in breast cancer stage and mortality by race/ethnicity in the United States are persistent and well known. However, few studies have assessed differences across racial/ethnic subgroups of women broadly defined as Hispanic, Asian, or Pacific Islander, particularly using more recent data. Using data from 17 population-based cancer registries in the Surveillance, Epidemiology, and End Results (SEER) program, we evaluated the relationships between race/ethnicity and breast cancer stage, hormone receptor status, treatment, and mortality. The cohort consisted of 229,594 women 40-79 years of age diagnosed with invasive breast carcinoma between January 2000 and December 2006, including 176,094 non-Hispanic whites, 20,486 Blacks, 15,835 Hispanic whites, 14,951 Asians, 1,224 Pacific Islanders, and 1,004 American Indians/Alaska Natives. With respect to statistically significant findings, American Indian/Alaska Native, Asian Indian/Pakistani, Black, Filipino, Hawaiian, Mexican, Puerto Rican, and Samoan women had 1.3-7.1-fold higher odds of presenting with stage IV breast cancer compared to non-Hispanic white women. Almost all groups were more likely to be diagnosed with estrogen receptor-negative/progesterone receptor-negative (ER-/PR-) disease with Black and Puerto Rican women having the highest odds ratios (2.4 and 1.9-fold increases, respectively) compared to non-Hispanic whites. Lastly, Black, Hawaiian, Puerto Rican, and Samoan patients had 1.5-1.8-fold elevated risks of breast cancer-specific mortality. Breast cancer disparities persist by race/ethnicity, though there is substantial variation within subgroups of women broadly defined as Hispanic or Asian. Targeted, multi-pronged interventions that are culturally appropriate may be important means of reducing the magnitudes of these disparities.

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