Regional and Racial Disparities in Breast Cancer Specific Mortality  

Oleh:

Grann, Victor ; Troxel, Andrea B. ; Zojwalla, Naseem ; Hershman, Dawn ; Glied, Sherry A. ; Jacobson, Judith S.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Social Science & Medicine (www.elsevier.com/locate/sosscimed) vol. 62 no. 2 (Jan. 2006), page 337-347.
Topik: racialism; united states; breast cancer specific mortality; geographical region; race / ethnicity; socioecoomic factors; SEER database

Ketersediaan

Perpustakaan Pusat (Semanggi) Nomor Panggil: SS53.1 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Where and how one lives is associated with cancer survival. This study was designed to assess geographical regon of residence, race / ethnicity and clinical and socio economic factors as predictors of survival in a population based cohort of women with breast cancer followed for upto 12 years. In a cohort of 218,879 breast cancer patients > 20 years of age at diagnosis, registered in the database of the US national cancer instititu's surveillance, epidemiology and end results (SEER) program between 1990 and 2001, we analyzed the association of breast cancer specific survival with SEER region : age, stage, histology, hormone receptor status, race / ethnicity and census data on educational attainment, income, employment, and insurance coverage. We comapred kaplan mesir survival curves by region and race / ethnicity. We used cox proportional hazards regression models to assess the association of mortality with region, race / ethnicity and the other variables. Women who lived in detroit had significantly higher mortality than those living in most other SEER regions. In most regions, black women had the poorest survival. The association of mortality than those living in the most other SEER regions. In most regions, black women had the poorest survival. The association of mortality with race did not significantly accross regions, but it was significantly stronger among wome 50 - 64 years of age thatn among women 65 and older. The SEER data document the association of breast cancer mortality with region, race and socioeconomic status. Black race was a strong predictor of mortality in each region even after controlling for socioeconomic factors. The diminishing effect of race with age, which may only partially be explained by insurance in those over 65, sugegsts a need for research on the role of other factors, such as comorbid conditions of access to care, in breast cancer mortality.

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