Survival differences in breast cancer among racial/ethnic groups: A population-based study

Boyer-Chammard, A Taylor, TH Anton-Culver, H

A. Boyer-chammard et al., Survival differences in breast cancer among racial/ethnic groups: A population-based study, CANCER DET, 23(6), 1999, pp. 463-473

39

INGLESE

Article

Oncology

CANCER DETECTION AND PREVENTION

0361-090X → ACNP

23

6

1999

463 - 473

ISI

0361-090X(1999)23:6<463:SDIBCA>2.0.ZU;2-0

In women, breast cancer is the most frequent solid tumor and the second lea ding cause of cancer death. Differences in survival of breast cancer have b een noted among racial/ethnic groups, but the reasons are unclear. This rep ort presents the characteristics and the survival experience of four racial /ethnic groups and evaluates the effects of stage, age, histology, and trea tment on survival time. The distributions of prognostic factors and treatme nt among racial/ethnic groups are compared using female breast cancer patie nts from two population-based registries in Southern California. The main e nd points are observed survival time and survival by cause of death. The Co x model is used to estimate the relative risk of death in three minority gr oups compared with non-Hispanic whites, while controlling for several covar iates. Breast cancer cases included in this study were 10,937 non-Hispanic whites, 185 blacks, 875 Hispanics, and 412 Asians. The median follow-up per iod was 76 months (range: 48-132). The median age at diagnosis was 64 years among non-Hispanic whites, 55 years among Hispanics (p = 0.001), 52 years among blacks (p = 0.001), and 50 years among Asians (p = 0.001). There was more localized disease among non-Hispanic whites (61.4%) than among blacks (50.8%) and Hispanics (52.2%), but not compared to Asians (59.7%). After co ntrolling for stage, age, histology, treatment, and registry, overall survi val significantly differed between non-Hispanic whites and blacks I[relativ e risk(RR) = 2.27, 95% confidence interval (95% CI) 1.82-2.84) and between non-Hispanic whites and Hispanics (RR = 1.18, 95% CI 1.04-1.34). The same r esults were found for breast cancer death in blacks (RR = 2.32, 95% CI 1.76 -3.07) and Hispanics (RR = 1.28, 95% CI 1.10-1.50). We: found no difference between Asians and non-Hispanic whites in overall and cancer-related survi val. These results show that stage of disease, age at diagnosis, histologic features and treatment for breast cancer differed among racial/ethnic grou ps. Moreover, black women, in particular, and Hispanic women with breast ca ncer had a higher risk of death compared to non-Hispanic white women, even after controlling for prognostic factors. These findings underline the nece ssity of improved screening and access to appropriate treatment among minor ity women for breast cancer.