Format

Send to

Choose Destination
Cancer Epidemiol Biomarkers Prev. 2016 Jul;25(7):1064-72. doi: 10.1158/1055-9965.EPI-15-1326. Epub 2016 Apr 26.

The Effect of Patient and Contextual Characteristics on Racial/Ethnic Disparity in Breast Cancer Mortality.

Author information

1
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California. Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California. rsposto@chla.usc.edu.
2
Division of Hematology and Oncology, Department of Internal Medicine, UC Davis Comprehensive Cancer Center, Sacramento, California.
3
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
4
Division of Research, Kaiser Permanente Northern California, Oakland, California.
5
City of Hope, Duarte, California.
6
Cancer Prevention Institute of California, Fremont, California. Stanford Cancer Institute, Stanford, California. Stanford University School of Medicine, Stanford, California.
7
Cancer Prevention Institute of California, Fremont, California. Stanford Cancer Institute, Stanford, California.
8
Cancer Prevention Institute of California, Fremont, California.
9
Stanford Cancer Institute, Stanford, California. Stanford University School of Medicine, Stanford, California.

Abstract

BACKGROUND:

Racial/ethnic disparity in breast cancer-specific mortality in the United States is well documented. We examined whether accounting for racial/ethnic differences in the prevalence of clinical, patient, and lifestyle and contextual factors that are associated with breast cancer-specific mortality can explain this disparity.

METHODS:

The California Breast Cancer Survivorship Consortium combined interview data from six California-based breast cancer studies with cancer registry data to create a large, racially diverse cohort of women with primary invasive breast cancer. We examined the contribution of variables in a previously reported Cox regression baseline model plus additional contextual, physical activity, body size, and comorbidity variables to the racial/ethnic disparity in breast cancer-specific mortality.

RESULTS:

The cohort comprised 12,098 women. Fifty-four percent were non-Latina Whites, 17% African Americans, 17% Latinas, and 12% Asian Americans. In a model adjusting only for age and study, breast cancer-specific HRs relative to Whites were 1.69 (95% CI, 1.46-1.96), 1.00 (0.84-1.19), and 0.52 (0.33-0.85) for African Americans, Latinas, and Asian Americans, respectively. Adjusting for baseline-model variables decreased disparity primarily by reducing the HR for African Americans to 1.13 (0.96-1.33). The most influential variables were related to disease characteristics, neighborhood socioeconomic status, and smoking status at diagnosis. Other variables had negligible impact on disparity.

CONCLUSIONS:

Although contextual, physical activity, body size, and comorbidity variables may influence breast cancer-specific mortality, they do not explain racial/ethnic mortality disparity.

IMPACT:

Other factors besides those investigated here may explain the existing racial/ethnic disparity in mortality. Cancer Epidemiol Biomarkers Prev; 25(7); 1064-72. ©2016 AACR.

PMID:
27197297
PMCID:
PMC4930680
DOI:
10.1158/1055-9965.EPI-15-1326
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center