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Contribution of clinical and socioeconomic factors to differences in breast cancer subtype and mortality between Hispanic and non-Hispanic white women.
Breast Cancer Res Treat. 2017 Nov; 166(1):185-193.BC

Abstract

PURPOSE

To assess tumor subtype distribution and the relative contribution of clinical and sociodemographic factors on breast cancer survival between Hispanic and non-Hispanic whites (NHWs).

METHODS

We analyzed data from the California Cancer Registry, which included 29,626 Hispanic and 99,862 NHW female invasive breast cancer cases diagnosed from 2004 to 2014. Logistic regression was used to assess ethnic differences in tumor subtype, and Cox proportional hazard modeling to assess differences in breast cancer survival.

RESULTS

Hispanics compared to NHWs had higher odds of having triple-negative (OR = 1.29; 95% CI 1.23-1.35) and HER2-overexpressing tumors (OR = 1.19; 95% CI 1.14-1.25 [HR-] and OR = 1.39; 95% CI 1.31-1.48 [HR+]). In adjusted models, Hispanic women had a higher risk of breast cancer mortality than NHW women (mortality rate ratio [MRR] = 1.24; 95% CI 1.19-1.28). Clinical factors accounted for most of the mortality difference (MRR = 1.05; 95% CI 1.01-1.09); however, neighborhood socioeconomic status (SES) and health insurance together accounted for all of the mortality difference (MRR = 1.01; 95% CI 0.97-1.05).

CONCLUSIONS

Addressing SES disparities, including increasing access to health care, may be critical to overcoming poorer breast cancer outcomes in Hispanics.

Authors+Show Affiliations

Moores Cancer Center, University of California, San Diego, 3855 Health Sciences Dr., #0901, La Jolla, CA, 92093-0829, USA. e8martinez@ucsd.edu. Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA. e8martinez@ucsd.edu.Cancer Prevention Institute of California, Fremont, CA, USA. Stanford Cancer Institute, Palo Alto, CA, USA.Cancer Prevention Institute of California, Fremont, CA, USA.California Cancer Registry, Public Health Institute, Sacramento, CA, USA.California Cancer Registry, Public Health Institute, Sacramento, CA, USA.Department of Surgery, University of California, San Diego, La Jolla, CA, USA.Department of Internal Medicine, University of New Mexico and the University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA.Moores Cancer Center, University of California, San Diego, 3855 Health Sciences Dr., #0901, La Jolla, CA, 92093-0829, USA. Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA.Department of Internal Medicine, University of New Mexico and the University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA.Maricopa Medical Center, Department of Surgery, Phoenix, AZ, USA.Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28698973

Citation

Martínez, María Elena, et al. "Contribution of Clinical and Socioeconomic Factors to Differences in Breast Cancer Subtype and Mortality Between Hispanic and non-Hispanic White Women." Breast Cancer Research and Treatment, vol. 166, no. 1, 2017, pp. 185-193.
Martínez ME, Gomez SL, Tao L, et al. Contribution of clinical and socioeconomic factors to differences in breast cancer subtype and mortality between Hispanic and non-Hispanic white women. Breast Cancer Res Treat. 2017;166(1):185-193.
Martínez, M. E., Gomez, S. L., Tao, L., Cress, R., Rodriguez, D., Unkart, J., Schwab, R., Nodora, J. N., Cook, L., Komenaka, I., & Li, C. (2017). Contribution of clinical and socioeconomic factors to differences in breast cancer subtype and mortality between Hispanic and non-Hispanic white women. Breast Cancer Research and Treatment, 166(1), 185-193. https://doi.org/10.1007/s10549-017-4389-z
Martínez ME, et al. Contribution of Clinical and Socioeconomic Factors to Differences in Breast Cancer Subtype and Mortality Between Hispanic and non-Hispanic White Women. Breast Cancer Res Treat. 2017;166(1):185-193. PubMed PMID: 28698973.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contribution of clinical and socioeconomic factors to differences in breast cancer subtype and mortality between Hispanic and non-Hispanic white women. AU - Martínez,María Elena, AU - Gomez,Scarlett L, AU - Tao,Li, AU - Cress,Rosemary, AU - Rodriguez,Danielle, AU - Unkart,Jonathan, AU - Schwab,Richard, AU - Nodora,Jesse N, AU - Cook,Linda, AU - Komenaka,Ian, AU - Li,Christopher, Y1 - 2017/07/11/ PY - 2017/03/27/received PY - 2017/07/07/accepted PY - 2017/7/13/pubmed PY - 2018/6/2/medline PY - 2017/7/13/entrez KW - Breast cancer KW - Disparities KW - Health insurance KW - Hispanic KW - Socioeconomic factors SP - 185 EP - 193 JF - Breast cancer research and treatment JO - Breast Cancer Res. Treat. VL - 166 IS - 1 N2 - PURPOSE: To assess tumor subtype distribution and the relative contribution of clinical and sociodemographic factors on breast cancer survival between Hispanic and non-Hispanic whites (NHWs). METHODS: We analyzed data from the California Cancer Registry, which included 29,626 Hispanic and 99,862 NHW female invasive breast cancer cases diagnosed from 2004 to 2014. Logistic regression was used to assess ethnic differences in tumor subtype, and Cox proportional hazard modeling to assess differences in breast cancer survival. RESULTS: Hispanics compared to NHWs had higher odds of having triple-negative (OR = 1.29; 95% CI 1.23-1.35) and HER2-overexpressing tumors (OR = 1.19; 95% CI 1.14-1.25 [HR-] and OR = 1.39; 95% CI 1.31-1.48 [HR+]). In adjusted models, Hispanic women had a higher risk of breast cancer mortality than NHW women (mortality rate ratio [MRR] = 1.24; 95% CI 1.19-1.28). Clinical factors accounted for most of the mortality difference (MRR = 1.05; 95% CI 1.01-1.09); however, neighborhood socioeconomic status (SES) and health insurance together accounted for all of the mortality difference (MRR = 1.01; 95% CI 0.97-1.05). CONCLUSIONS: Addressing SES disparities, including increasing access to health care, may be critical to overcoming poorer breast cancer outcomes in Hispanics. SN - 1573-7217 UR - https://www.unboundmedicine.com/medline/citation/28698973/Contribution_of_clinical_and_socioeconomic_factors_to_differences_in_breast_cancer_subtype_and_mortality_between_Hispanic_and_non_Hispanic_white_women_ L2 - https://doi.org/10.1007/s10549-017-4389-z DB - PRIME DP - Unbound Medicine ER -