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The joint contribution of tumor phenotype and education to breast cancer survival disparity between Hispanic and non-Hispanic white women.
Cancer Causes Control. 2014 Mar; 25(3):273-82.CC

Abstract

Some studies suggest that Hispanic women are more likely to have ER- and triple-negative (ER-/PR-/HER2-) tumors and subsequently poorer prognosis than non-Hispanic white (NHW) women. In addition, only a handful of studies have examined period-specific effects of tumor phenotype and ethnicity on breast cancer survival, leaving the time-varying effects of hormonal status and ethnicity on breast cancer survival poorly defined. This study describes short and long-term breast cancer survival by ethnicity at 0-5 years and 5+ years post-diagnosis using data from the New Mexico Health, Eating, Activity, and Lifestyle cohort of Hispanic and NHW women ages 29-88 years newly diagnosed with stages I-IIIA breast cancer. The survival rate for Hispanics at 0-5 years was 82.2 % versus 94.3 % for NHW. Hispanics were more likely to have larger tumors, more advanced stage, and ER- phenotypes compared to NHW women. There was a significantly higher risk of breast cancer mortality in Hispanics over 5 years of follow-up compared to NHW (HR = 2.78, 95 % CI 1.39-5.56), adjusting for age, tumor phenotype, stage, and tumor size. This ethnic difference in survival, however, was attenuated and no longer statistically significant when additional adjustment was made for education, although a >1.5-fold increase in mortality was observed. In contrast, there was no difference between ethnic groups for survival after 5 years (HR = 1.08, 95 % CI 0.36-3.24). Our results indicate that the difference in survival between Hispanic and NHW women with breast cancer occurs in the first few years following diagnosis and is jointly associated with tumor phenotype and socio-demographic factors related to education.

Authors+Show Affiliations

Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, 40202, USA, srdenk01@louisville.edu.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

24337810

Citation

Boone, S D., et al. "The Joint Contribution of Tumor Phenotype and Education to Breast Cancer Survival Disparity Between Hispanic and non-Hispanic White Women." Cancer Causes & Control : CCC, vol. 25, no. 3, 2014, pp. 273-82.
Boone SD, Baumgartner KB, Joste NE, et al. The joint contribution of tumor phenotype and education to breast cancer survival disparity between Hispanic and non-Hispanic white women. Cancer Causes Control. 2014;25(3):273-82.
Boone, S. D., Baumgartner, K. B., Joste, N. E., Pinkston, C. M., Yang, D., & Baumgartner, R. N. (2014). The joint contribution of tumor phenotype and education to breast cancer survival disparity between Hispanic and non-Hispanic white women. Cancer Causes & Control : CCC, 25(3), 273-82. https://doi.org/10.1007/s10552-013-0329-3
Boone SD, et al. The Joint Contribution of Tumor Phenotype and Education to Breast Cancer Survival Disparity Between Hispanic and non-Hispanic White Women. Cancer Causes Control. 2014;25(3):273-82. PubMed PMID: 24337810.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The joint contribution of tumor phenotype and education to breast cancer survival disparity between Hispanic and non-Hispanic white women. AU - Boone,S D, AU - Baumgartner,K B, AU - Joste,N E, AU - Pinkston,C M, AU - Yang,D, AU - Baumgartner,R N, Y1 - 2013/12/14/ PY - 2013/07/31/received PY - 2013/12/04/accepted PY - 2013/12/17/entrez PY - 2013/12/18/pubmed PY - 2014/11/14/medline SP - 273 EP - 82 JF - Cancer causes & control : CCC JO - Cancer Causes Control VL - 25 IS - 3 N2 - Some studies suggest that Hispanic women are more likely to have ER- and triple-negative (ER-/PR-/HER2-) tumors and subsequently poorer prognosis than non-Hispanic white (NHW) women. In addition, only a handful of studies have examined period-specific effects of tumor phenotype and ethnicity on breast cancer survival, leaving the time-varying effects of hormonal status and ethnicity on breast cancer survival poorly defined. This study describes short and long-term breast cancer survival by ethnicity at 0-5 years and 5+ years post-diagnosis using data from the New Mexico Health, Eating, Activity, and Lifestyle cohort of Hispanic and NHW women ages 29-88 years newly diagnosed with stages I-IIIA breast cancer. The survival rate for Hispanics at 0-5 years was 82.2 % versus 94.3 % for NHW. Hispanics were more likely to have larger tumors, more advanced stage, and ER- phenotypes compared to NHW women. There was a significantly higher risk of breast cancer mortality in Hispanics over 5 years of follow-up compared to NHW (HR = 2.78, 95 % CI 1.39-5.56), adjusting for age, tumor phenotype, stage, and tumor size. This ethnic difference in survival, however, was attenuated and no longer statistically significant when additional adjustment was made for education, although a >1.5-fold increase in mortality was observed. In contrast, there was no difference between ethnic groups for survival after 5 years (HR = 1.08, 95 % CI 0.36-3.24). Our results indicate that the difference in survival between Hispanic and NHW women with breast cancer occurs in the first few years following diagnosis and is jointly associated with tumor phenotype and socio-demographic factors related to education. SN - 1573-7225 UR - https://www.unboundmedicine.com/medline/citation/24337810/The_joint_contribution_of_tumor_phenotype_and_education_to_breast_cancer_survival_disparity_between_Hispanic_and_non_Hispanic_white_women_ L2 - https://doi.org/10.1007/s10552-013-0329-3 DB - PRIME DP - Unbound Medicine ER -