The California Breast Cancer Survivorship Consortium (CBCSC): prognostic factors associated with racial/ethnic differences in breast cancer survival
- 713 Downloads
Racial/ethnic disparities in mortality among US breast cancer patients are well documented. Our knowledge of the contribution of lifestyle factors to disease prognosis is based primarily on non-Latina Whites and is limited for Latina, African American, and Asian American women. To address this knowledge gap, the California Breast Cancer Survivorship Consortium (CBCSC) harmonized and pooled interview information (e.g., demographics, family history of breast cancer, parity, smoking, alcohol consumption) from six California-based breast cancer studies and assembled corresponding cancer registry data (clinical characteristics, mortality), resulting in 12,210 patients (6,501 non-Latina Whites, 2,060 African Americans, 2,032 Latinas, 1,505 Asian Americans, 112 other race/ethnicity) diagnosed with primary invasive breast cancer between 1993 and 2007. In total, 3,047 deaths (1,570 breast cancer specific) were observed with a mean (SD) follow-up of 8.3 (3.5) years. Cox proportional hazards regression models were fit to data to estimate hazards ratios (HRs) and 95 % confidence intervals (CIs) for overall and breast cancer-specific mortality. Compared with non-Latina Whites, the HR of breast cancer-specific mortality was 1.13 (95 % CI 0.97–1.33) for African Americans, 0.84 (95 % CI 0.70–1.00) for Latinas, and 0.60 (95 % CI 0.37–0.97) for Asian Americans after adjustment for age, tumor characteristics, and select lifestyle factors. The CBCSC represents a large and racially/ethnically diverse cohort of breast cancer patients from California. This cohort will enable analyses to jointly consider a variety of clinical, lifestyle, and contextual factors in attempting to explain the long-standing disparities in breast cancer outcomes.
KeywordsRace/ethnicity Survival Tumor characteristics Lifestyle factors
We are grateful to all the study participants for their contributions in the six California-based studies. We thank Juan Yang and Rita Leung at CPIC and Chiu-Chen Tseng at USC for their analytic support. This work was supported by grants (16ZB-8001 (USC, Wu), 16ZB-8002 (CPIC, Gomez), 16ZB-8003 (COH, Bernstein), 16ZB-8004 (KPNC, Kwan), 16ZB-8005 (USC, Monroe) from the California Breast Cancer Research Program. The Asian American Breast Cancer Study was supported by the California Breast Research Program (CBCRP) grants 1RB-0287, 3PB-0120, and 5PB-0018. The San Francisco Bay Area Breast Cancer Study was supported by National Cancer Institute grants R01 CA63446 and R01 CA77305, by the U.S. Department of Defense (DOD) grant DAMD17-96-1-6071, and by the CBCRP grants 4JB-1106 and 7PB-0068. The Women’s CARE Study was funded by the National Institute of Child Health and Human Development (NICHD), through a contract with USC (N01-HD-3-3175); and the California Teachers Study was funded by the California Breast Cancer Act of 1993, National Cancer Institute grants (R01 CA77398 and K05 CA136967 to LB), and the California Breast Cancer Research Fund (contract 97-10500). The Multiethnic Cohort Study was supported by National Cancer Institute grants R01 CA54281, R37CA54281, and UM1 CA164973. The Life After Cancer Epidemiology Study is supported by National Cancer Institute grant R01 CA129059. Clinical and tumor characteristics and mortality data were obtained from the California Cancer Registry (CCR), also part of the National Cancer Institute’s Division of Cancer Prevention and Control Surveillance, Epidemiology, and End Results Program, under contract number N01CN25403. The collection of cancer incidence data used in this study 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 National Cancer Institute’s Surveillance, Epidemiology, and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California, contract HHSN26120100035C awarded to the University of Southern California, and contract HHSN26120100034C awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement #1U58 DP000807-01 awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the authors, and endorsement by the State of California, the California Department of Health Services, the National Cancer Institute, or the Centers for Disease Control and Prevention or their contractors and subcontractors is not intended nor should be inferred.
Conflict of interest
- 47.Center PH (2009) Demographic profile of Hispanics in California. http://pewhispanic.org/states/?stateid=CA