, Volume 17, Issue 2, pp 217-226

Race/Ethnicity and Changing US Socioeconomic Gradients in Breast Cancer Incidence: California and Massachusetts, 1978–2002 (United States)

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Objective We tested the hypothesis that the US socioeconomic gradient in breast cancer incidence is declining, with the decline most pronounced among racial/ethnic groups with the highest incidence rates.

Methods We geocoded the invasive incident breast cancer cases for three US population-based cancer registries covering: Los Angeles County, CA (1978–1982, 1988–1992, 1998–2002; n = 68,762 cases), the San Francisco Bay Area, CA (1978–1982, 1988–1992, 1998–2002; n = 37,210 cases) and Massachusetts (1988–1992, 1998–2002; n = 48,111 cases), linked the records to census tract area-based socioeconomic measures, and, for each socioeconomic stratum, computed average annual breast cancer incidence rates for the 5-year period straddling the 1980, 1990, and 2000 census, overall and by race/ethnicity and gender.

Results Our findings indicate that the socioeconomic gradient in breast cancer incidence is: (a) relatively small (at most 1.2) and stable among US white non-Hispanic and black women; (b) sharper and generally increasing among Hispanic and Asian and Pacific Islander American women; and (c) cannot be meaningfully analyzed without considering effect modification by race/ethnicity and immigration.

Conclusion Our results indicate that secular changes in US socioeconomic gradients in breast cancer incidence exist and vary by race/ethnicity.

Funding: This investigation was supported by a grant from the National Cancer Institute, National Institutes of Health, Department of Health and Human Services (R01 CA095983-01). The effort involving the California cancer registry data has been funded in whole or in part with Federal funds from the National Cancer Institute, National Institutes of Health, Department of Health and Human Services, under Contract no. N01-PC-35139. The collection of cancer incidence data used in this publication was supported by the California Department of Health Services as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885. The ideas and opinions expressed herein are those of the authors, and no endorsement by the State of California Department of Health Services is intended or should be inferred. Additionally, the Massachusetts data were collected as part of participation in the National Program of Cancer Registries (NPCR) of the Centers for Disease Control and Prevention (CDC).