Details:

Alternative Title:
Cancer Epidemiol Biomarkers Prev
Personal Author:
Sposto, Richard ; Keegan, Theresa H. M. ; Vigen, Cheryl ; Kwan, Marilyn L. ; Bernstein, Leslie ; ... More +
Sposto, Richard ; Keegan, Theresa H. M. ; Vigen, Cheryl ; Kwan, Marilyn L. ; Bernstein, Leslie ; John, Esther M. ; Cheng, Iona ; Yang, Juan ; Koo, Jocelyn ; Kurian, Allison W. ; Caan, Bette J. ; Lu, Yani ; Monroe, Kristine R. ; Shariff-Marco, Salma ; Gomez, Scarlett Lin ; Wu, Anna H. Less -
Description:
Background

Racial/ethnic disparity in breast cancer-specific mortality in the U.S. 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 hazard ratios 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 hazard ratio 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

While 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.


Subject:
[+]
African Americans
Asian Americans
Body Size
Breast Neoplasms/ethnology
Breast Neoplasms/mortality
Cohort Studies
Comorbidity
Exercise
Female
Healthcare Disparities
Hispanic Or Latino
Humans
Proportional Hazards Models
Risk Factors
Whites

Source:
Cancer Epidemiol Biomarkers Prev. 25(7):1064-1072.
Pubmed ID:
27197297
Pubmed Central ID:
PMC4930680
Document Type:
Journal Article
Funding:
UM1 CA164973/CA/NCI NIH HHS/United States ; N01 HD033175/HD/NICHD NIH HHS/United States ; HHSN261201000035C/PC,CA/None/None ; HHSN261201000140C/CA/NCI NIH HHS/United States ; R01 CA129059/CA/NCI NIH HHS/United States ; ... More +
UM1 CA164973/CA/NCI NIH HHS/United States ; N01 HD033175/HD/NICHD NIH HHS/United States ; HHSN261201000035C/PC,CA/None/None ; HHSN261201000140C/CA/NCI NIH HHS/United States ; R01 CA129059/CA/NCI NIH HHS/United States ; U58 DP000807/DP/NCCDPHP CDC HHS/United States ; K05 CA136967/CA/NCI NIH HHS/United States ; HHSN261201000035I/CA/NCI NIH HHS/United States ; R01 CA063446/CA/NCI NIH HHS/United States ; R01 CA077398/CA/NCI NIH HHS/United States ; R01 CA054281/CA/NCI NIH HHS/United States ; HHSN261201000034C/CA/NCI NIH HHS/United States ; U58 DP003862/DP/NCCDPHP CDC HHS/United States ; R37 CA054281/CA/NCI NIH HHS/United States Less -
Place as Subject:
California
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:ba678984ebb2e6f052e67ac8cb487facea462aa05dddacfa6fc797dfc5f7d5c6
File Type:

Supporting Files

• 	NIHMS780159-supplement-1.docx	docx
  	NIHMS780159-supplement-2.docx	docx
  	nihms780159.nxml	bin
  	nihms780159f1.gif	gif
  	nihms780159f1.jpg	jpeg
  	nihms780159f2.gif	gif
  	nihms780159f2.jpg	jpeg

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