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Cancer Epidemiol. 2014 Apr;38(2):118-23. doi: 10.1016/j.canep.2013.09.009. Epub 2014 Mar 4.

Increasing Black:White disparities in breast cancer mortality in the 50 largest cities in the United States.

Author information

1
Sinai Urban Health Institute, Room K443, Mount Sinai Hospital, 1500 South California Avenue, Chicago, IL 60608-1797, USA. Electronic address: Bijou.Hunt@sinai.org.
2
Sinai Urban Health Institute, Room K437, Mount Sinai Hospital, 1500 South California Avenue, Chicago, IL 60608-1797, USA. Electronic address: Steve.Whitman@sinai.org.
3
Avon Foundation Breast Cancer Crusade, 777 Third Avenue, New York, NY 10017, USA. Electronic address: Marc.Hurlbert@avonfoundation.org.

Abstract

INTRODUCTION:

This paper presents race-specific breast cancer mortality rates and the corresponding rate ratios for the 50 largest U.S. cities for each of the 5-year intervals between 1990 and 2009.

METHODS:

The 50 largest cities in the U.S. were the units of analysis. Numerator data were abstracted from national death files where the cause was malignant neoplasm of the breast (ICD-9=174 and ICD-10=C50) for women. Population-based denominators were obtained from the U.S. Census Bureau for 1990, 2000, and 2010. To measure the racial disparity, we calculated non-Hispanic Black:non-Hispanic White rate ratios (RRs) and confidence intervals for each 5-year period.

RESULTS:

At the final time point (2005-2009), two RRs were less than 1, but neither significantly so, while 39 RRs were >1, 23 of them significantly so. Of the 41 cities included in the analysis, 35 saw an increase in the Black:White RR between 1990-1994 and 2005-2009. In many of the cities, the increase in the disparity occurred because White rates improved substantially over the 20-year study period, while Black rates did not. There were 1710 excess Black deaths annually due to this disparity in breast cancer mortality, for an average of about 5 each day.

CONCLUSION:

This analysis revealed large and growing disparities in Black:White breast cancer mortality in the U.S. and many of its largest cities during the period 1990-2009. Much work remains to achieve equality in breast cancer mortality outcomes.

KEYWORDS:

Big cities; Breast cancer; Racial disparities

PMID:
24602836
DOI:
10.1016/j.canep.2013.09.009
[Indexed for MEDLINE]
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