Racial/ethnic disparities in survival after breast cancer diagnosis by estrogen and progesterone receptor status: A pooled analysis

Details

• Alternative Title:
  Cancer Epidemiol Biomarkers Prev
• Personal Author:
  John, Esther M. ; McGuire, Valerie ; Kurian, Allison W. ; Koo, Jocelyn ; Shariff-Marco, Salma ; Gomez, Scarlett Lin ; Cheng, Iona ; Keegan, Theresa H.M. ; Kwan, Marilyn L. ; Bernstein, Leslie ; Vigen, Cheryl ; Wu, Anna H.
• Description:
  Background:
  
  Limited studies have investigated racial/ethnic survival disparities for breast cancer (BC) defined by estrogen receptor (ER) and progesterone receptor (PR) status in a multiethnic population.
  
  Methods:
  
  Using multivariable Cox proportional hazards models, we assessed associations of race/ethnicity with ER/PR-specific BC mortality in 10,366 Californian women diagnosed with BC from 1993-2009. We evaluated joint associations of race/ethnicity, healthcare, sociodemographic, and lifestyle factors with mortality.
  
  Results:
  
  Among women with ER/PR+ BC, BC-specific mortality was similar among Hispanic and Asian American women, but higher among African American women (hazard ratio (HR) 1.31, 95% confidence interval 1.05-1.63) compared to non-Hispanic White (NHW) women. BC-specific mortality was modified by surgery type, hospital type, education, neighborhood socioeconomic status (SES), smoking history, and alcohol consumption. Among African American women, BC-specific mortality was higher among those treated at non-accredited hospitals (HR 1.57, CI 1.21-2.04) and those from lower SES neighborhoods (HR 1.48, CI 1.16-1.88) compared to NHW women without these characteristics. BC-specific mortality was higher among African American women with at least some college education (HR 1.42, CI 1.11-1.82) compared to NHW women with similar education. For ER−/PR− disease, BC-specific mortality did not differ by race/ethnicity and associations of race/ethnicity with BC-specific mortality varied only by neighborhood SES among African American women.
  
  Conclusions:
  
  Racial/ethnic survival disparities are more striking for ER/PR+ than ER−PR− BC. Social determinants and lifestyle factors may explain some of the survival disparities for ER/PR+ BC.
  
  Impact:
  
  Addressing these factors may help reduce the higher mortality of African American women with ER/PR+ BC.
  
  
• Subjects:
  Article
• Source:
  Cancer Epidemiol Biomarkers Prev. 30(2):351-363
• Pubmed ID:
  33355191
• Pubmed Central ID:
  PMC7867638
• Document Type:
  Journal Article
• Funding:
  HHSN261201800032C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009C/CA/NCI NIH HHSUnited States/ ; NU58DP006344/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201800015I/CA/NCI NIH HHSUnited States/ ; R01 CA129059/CA/NCI NIH HHSUnited States/ ; K05 CA136967/CA/NCI NIH HHSUnited States/ ; U01 CA164920/CA/NCI NIH HHSUnited States/ ; HHSN261201800032I/CA/NCI NIH HHSUnited States/ ; HHSN261201800015C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009I/CA/NCI NIH HHSUnited States/ ; R01 CA063446/CA/NCI NIH HHSUnited States/ ; R01 CA077398/CA/NCI NIH HHSUnited States/ ; R01 CA054281/CA/NCI NIH HHSUnited States/ ; U01 CA164973/CA/NCI NIH HHSUnited States/ ; R37 CA054281/CA/NCI NIH HHSUnited States/
• Volume:
  30
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:b07a510ad872b4f9f55390a4e1366f275496427cf5839b3b75bf125c09290d21
• Download URL:
  https://stacks.cdc.gov/view/cdc/102578/cdc_102578_DS1.pdf
• File Type:
  [PDF - 820.51 KB ]