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Racial and socioeconomic disparities in breast cancer diagnosis and mortality in Pennsylvania

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Many studies have demonstrated disparities in breast cancer (BC) incidence and mortality among Black women. We hypothesized that in Pennsylvania (PA), a large economically diverse state, BC diagnosis and mortality would be similar among races when stratified by a municipality’s median income.

Methods

We collected the frequencies of BC diagnosis and mortality for years 2011–2015 from the Pennsylvania Cancer Registry and demographics from the 2010 US Census. We analyzed BC diagnoses and mortalities after stratifying by median income, municipality size, and race with univariable and multivariable logistic regression models.

Results

In this cohort, of 5,353,875 women there were 54,038 BC diagnoses (1.01% diagnosis rate) and 9,828 BC mortalities (0.18% mortality rate). Unadjusted diagnosis rate was highest among white women (1.06%) but Black women had a higher age-adjusted diagnosis rate (1.06%) than white women (1.02%). Race, age and income were all significantly associated with BC diagnosis, but there were no differences in BC diagnosis between white and Black women across all levels of income in the multivariable model. BC mortality was highest in Black women, a difference which persisted when adjusted for age. Black women 35 years and older had a higher mortality rate in all income quartiles.

Conclusion

We found that in PA, age, race and income are all associated with BC diagnosis and mortality with noteworthy disparities for Black women. Continued surveillance of differences in both breast cancer diagnosis and mortality, and targeted interventions related to education, screening and treatment may help to eliminate these socioeconomic and racial disparities.

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Data availability

All data used are publicly accessible via the Pennsylvania Cancer Registry and the US Census Bureau.

Code availability

Not applicable.

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Acknowledgements

A portion of the data used in this study were provided by the Division of Health Informatics, Pennsylvania Department of Health. The Department specifically disclaims responsibility for any analyses, interpretations, or conclusions.

Funding

None to disclose.

Author information

Authors and Affiliations

  1. Department of Surgery, Lankenau Medical Center, Wynnewood, PA, USA

    Austin D. Williams, Robin M. Ciocca, Jennifer L. Sabol & Ned Z. Carp

  2. Main Line Health Center for Population Health Research at Lankenau Institute for Medical Research, Wynnewood, PA, USA

    Meghan Buckley & Sharon L. Larson

Authors
  1. Austin D. Williams
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  2. Meghan Buckley
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  3. Robin M. Ciocca
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  4. Jennifer L. Sabol
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Correspondence to Austin D. Williams.

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Deemed exempt by the Main Line Health System IRB.

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Williams, A.D., Buckley, M., Ciocca, R.M. et al. Racial and socioeconomic disparities in breast cancer diagnosis and mortality in Pennsylvania. Breast Cancer Res Treat 192, 191–200 (2022). https://doi.org/10.1007/s10549-021-06492-1

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  • DOI: https://doi.org/10.1007/s10549-021-06492-1

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