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Regional and racial disparities in breast cancer-specific mortality.
Soc Sci Med 2006; 62(2):337-47SS

Abstract

Where and how one lives is associated with cancer survival. This study was designed to assess geographical region of residence, race/ethnicity, and clinical and socioeconomic factors as predictors of survival in a population based cohort of women with breast cancer followed for up to 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 Institute'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 compared Kaplan-Meier 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 with race did not differ significantly across regions, but it was significantly stronger among women 50-64 years of age than 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, suggests a need for research on the role of other factors, such as comorbid conditions or access to care, in breast cancer mortality.

Authors+Show Affiliations

Department of Medicine, Columbia University, New York, NY 10021, USA. vrg2@columbia.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16051406

Citation

Grann, Victor, et al. "Regional and Racial Disparities in Breast Cancer-specific Mortality." Social Science & Medicine (1982), vol. 62, no. 2, 2006, pp. 337-47.
Grann V, Troxel AB, Zojwalla N, et al. Regional and racial disparities in breast cancer-specific mortality. Soc Sci Med. 2006;62(2):337-47.
Grann, V., Troxel, A. B., Zojwalla, N., Hershman, D., Glied, S. A., & Jacobson, J. S. (2006). Regional and racial disparities in breast cancer-specific mortality. Social Science & Medicine (1982), 62(2), pp. 337-47.
Grann V, et al. Regional and Racial Disparities in Breast Cancer-specific Mortality. Soc Sci Med. 2006;62(2):337-47. PubMed PMID: 16051406.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Regional and racial disparities in breast cancer-specific mortality. AU - Grann,Victor, AU - Troxel,Andrea B, AU - Zojwalla,Naseem, AU - Hershman,Dawn, AU - Glied,Sherry A, AU - Jacobson,Judith S, Y1 - 2005/07/26/ PY - 2004/08/10/received PY - 2005/7/30/pubmed PY - 2006/6/7/medline PY - 2005/7/30/entrez SP - 337 EP - 47 JF - Social science & medicine (1982) JO - Soc Sci Med VL - 62 IS - 2 N2 - Where and how one lives is associated with cancer survival. This study was designed to assess geographical region of residence, race/ethnicity, and clinical and socioeconomic factors as predictors of survival in a population based cohort of women with breast cancer followed for up to 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 Institute'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 compared Kaplan-Meier 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 with race did not differ significantly across regions, but it was significantly stronger among women 50-64 years of age than 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, suggests a need for research on the role of other factors, such as comorbid conditions or access to care, in breast cancer mortality. SN - 0277-9536 UR - https://www.unboundmedicine.com/medline/citation/16051406/Regional_and_racial_disparities_in_breast_cancer_specific_mortality_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0277-9536(05)00298-4 DB - PRIME DP - Unbound Medicine ER -