Cancer Causes & Control

, Volume 24, Issue 9, pp 1705–1715

Disparities in survival after female breast cancer diagnosis: a population-based study

  • Stacey L. Tannenbaum
  • Tulay Koru-Sengul
  • Feng Miao
  • Margaret M. Byrne
Original paper

DOI: 10.1007/s10552-013-0246-5

Cite this article as:
Tannenbaum, S.L., Koru-Sengul, T., Miao, F. et al. Cancer Causes Control (2013) 24: 1705. doi:10.1007/s10552-013-0246-5

Abstract

Background

Despite advances in treatment and increased screening, female breast cancer survival is affected by race, ethnicity, and socioeconomic status (SES). The purpose of this study was to substantiate disparities in breast cancer mortality in a large and unique dataset containing 7 distinct racial groups, 31 comorbidities, demographic and clinical/pathological patient characteristics, and neighborhood poverty information.

Methods

Florida Cancer Data System registry (1996–2007) linked with the Agency for Health Care Administration and U.S. Census tract (n = 127,754) explored median survival and 1-, 3-, and 5-year survival rates by the Kaplan–Meier method. Log-rank tests compared survival curves by race/ethnicity/SES. Cox proportional hazards regression models were used to obtain unadjusted and adjusted hazard ratios (HR) and 95 % confidence intervals.

Results

Native Americans had the lowest median survival (7.4 years) and Asians had the highest (12.6 years). For the univariate analysis, worse survival was seen for blacks (HR = 1.44; p < 0.001) and better survival for Asians (HR = 0.71; p < 0.001), Asian Indians or Pakistanis (HR = 0.65; p = 0.013), and Hispanics (HR = 0.92; p < 0.001). Multivariate analysis demonstrated sustained survival detriment for blacks (HR = 1.28; p < 0.001) and improved survival for Hispanics (HR = 0.90; p = 0.001). For SES, there was an incremental improvement in survival for each higher SES category in all analyses (p < 0.001).

Conclusions

Utilizing a large enriched state cancer registry controlling for multiple demographic, clinical, and comorbidities, we fully explored survival disparities in female breast cancer and found certain aspects of race, ethnicity, and SES to remain significantly associated with breast cancer survival. More research is needed to uncover the source of these ongoing disparities.

Keywords

Breast cancer Survival analysis Health care disparities Ethnicity Socioeconomic status Patient outcomes assessment 

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Stacey L. Tannenbaum
    • 1
  • Tulay Koru-Sengul
    • 2
  • Feng Miao
    • 1
  • Margaret M. Byrne
    • 2
    • 3
  1. 1.Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of MedicineMiamiUSA
  2. 2.Department of Public Health Sciences, Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of MedicineMiamiUSA
  3. 3.Department of Surgery, Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of MedicineMiamiUSA

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