Racial/ethnic variation in clinical presentation, treatment, and survival among breast cancer patients under age 35

Cancer - Tập 97 Số 1 - Trang 134-147 - 2003
Vickie L. Shavers1,2, Linda C. Harlan1, Jennifer Stevens3
1Applied Research Program, Health Service and Economics Branch, Division of Cancer Control and Population Science, National Cancer Institute, Bethesda, Maryland
2Fax (301) 434-3710
3Information Management Systems, Silver Spring, Maryland

Tóm tắt

AbstractBACKGROUNDThe age specific breast cancer incidence rate for African‐American women under age 35 is more than twice the rate for white women of similar age, and the mortality rate is more than three times higher. To determine factors that may explain racial/ethnic variation in outcomes among young women diagnosed with breast cancer, the authors examined the clinical presentation, treatment, and survival of African‐American, Hispanic, and white women under age 35 years.METHODSSurveillance, Epidemiology, and End Results (SEER) Program data for 1990–1998 and SEER Patterns of Care data for 1990, 1991, and 1995 were used for this analysis. Multivariate logistic regression analyses were performed to examine factors associated with the receipt of selected breast cancer treatments. Kaplan–Meier survival analyses and Cox proportional hazards regression analyses were used to examine 5‐year overall survival and disease‐specific survival.RESULTSThe authors found racial/ethnic variation in clinical presentation, treatment, and survival. Both African‐American and Hispanic women presented with higher disease stage and a higher prevalence of adverse prognostic indicators compared to white women. African‐American and Hispanic women received cancer‐directed surgery and radiation less frequently after undergoing breast‐conserving surgery. Racial/ethnic differences in clinical presentation and treatment were associated with poorer overall survival in unadjusted analyses. African‐American and Hispanic women also had poorer overall survival after controlling for clinical and demographic characteristics and type of treatment.CONCLUSIONSFuture research studies should further examine the factors that influence racial/ethnic differences in incidence, clinical presentation, and treatment differentials among young women diagnosed with breast cancer. A better understanding of these factors will facilitate the development of strategies to help eliminate this health disparity. Cancer 2003;97:134–47. Published 2003 by the American Cancer Society.DOI 10.1002/cncr.11051

Từ khóa


Tài liệu tham khảo

American Cancer Society, 2002, Cancer facts and figures, 2002

American Cancer Society, 2002, Breast cancer facts and figures, 2001–2002

10.1002/(SICI)1097-0142(19960101)77:1<97::AID-CNCR16>3.0.CO;2-3

10.1016/S1072-7515(00)00257-X

10.1002/ijc.2910620205

10.1016/S0360-3016(98)90004-9

10.1111/j.1445-2197.1997.tb04575.x

10.1016/0360-3016(94)90515-0

10.1002/1096-9098(200008)74:4<267::AID-JSO5>3.0.CO;2-N

Molnar L, 1995, Cancer of the breast in young women, Acta Chir Hungary., 35, 5

Chapuis L, 1989, Breast cancer before 36 years of age, Helv Chir Acta., 55, 895

10.1002/(SICI)1097-0142(19981215)83:12<2509::AID-CNCR15>3.0.CO;2-V

Ries LAG, 2001, SEER cancer statistics review 1973–1998

10.1093/jnci/86.9.705

10.1002/(SICI)1097-0215(19971104)73:3<349::AID-IJC8>3.0.CO;2-#

Swanson GM, 1994, Survival patterns among younger women with breast cancer: the effects of age, race, stage and treatment, J Natl Cancer Inst Mongr., 16, 69

10.1016/0021-9681(87)90171-8

Surveillance Epidemiology and End Results (SEER) Program. SEER public‐use data (1973–1998) [released April 2001 based on the August 2000 submission]. Bethesda: National Cancer Institute DCCPS Surveillance Research Program Cancer Statistics Branch 2000.

SAS Institute, 2001, SAS version 8.5

Research Triangle Institute, 2001, SUDAAN

10.3349/ymj.2000.41.3.312

10.1023/A:1006480106487

10.1111/j.1445-2197.1991.tb00213.x

10.1038/bjc.1996.248

Phillips JM, 1999, Breast cancer screening and African American women: fear, fatalism, and silence, Oncol Nurs Forum., 26, 561

10.1023/A:1018776704683

10.1016/S0749-3797(18)30134-X

10.1300/J074v13n01_05

Powe BD, 1995, Cancer fatalism among elderly Caucasians and African Americans, Oncol Nurs Forum., 22, 1355

10.1097/00002820-199510000-00008

10.1097/00005650-200004000-00011

10.1023/A:1013960609008

Fodor J, 2000, The impact of radiotherapy on the incidence and time of occurrence of local recurrence in early stage breast cancer after breast conserving therapy, Neoplasma., 47, 181

10.1002/1096-9098(200008)74:4<273::AID-JSO6>3.0.CO;2-V

10.1016/S0360-3016(00)00715-X

10.1016/S1072-7515(98)00114-8

10.1093/jnci/94.7.490

10.1097/00005650-199610000-00003

10.1093/jnci/88.11.716

Thông tin
Thông tin xuất bản

Cancer

Tập 97 Số 1

134-147

Thông tin tác giả