ABSTRACT: Differences in Breast Cancer Stage, Treatment, and Survival
by Race and Ethnicity
Background: In the United States, black and Hispanic white women
with breast cancer present with more advanced stages and have
poorer survival rates than non-Hispanic whites, whereas Asians
and Pacific Islanders do not. However, Asians and Pacific Islanders
and Hispanic whites are heterogeneous populations, and few studies
have evaluated breast cancer stage, treatments, and mortality
rates for subgroups of these populations.
Methods: Using data from 11 population-based tumor registries that
participate in the Surveillance, Epidemiology, and End Results
Program, we conducted a retrospective cohort study to evaluate
the relationship between race and ethnicity and breast cancer
stage, treatments, and mortality rates.
The cohort of 124934
women diagnosed as having a first primary invasive breast
carcinoma between January 1, 1992, and December 31, 1998,
included 97999 non-Hispanic whites, 10560 blacks, 322
American Indians, 8834 Asians and Pacific Islanders, and
7219 Hispanic whites.
Results: Relative to non-Hispanic whites, blacks, American
Indians, Hawaiians, Indians and Pakistanis, Mexicans, South
and Central Americans, and Puerto Ricans had 1.4- to 3.6-fold
greater risks of presenting with stage IV breast cancer.
Blacks, Mexicans, and Puerto Ricans were 20% to 50% more
likely to receive or elect a first course of surgical and radiation
treatment not meeting the 2000 National Comprehensive Cancer
Network standards. In addition, blacks, American Indians, Hawaiians,
Vietnamese, Mexicans, South and Central Americans, and Puerto
Ricans had 20% to 200% greater risks of mortality after a breast
Conclusions: Differences in breast cancer stage, treatments,
and mortality rates are present by race and ethnicity.
Breast cancer survival may be improved by targeting factors,
particularly socioeconomic factors, that underlie these differences.
[01/14/2003; Archives Of Internal Medicine]
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