Differences in Breast Cancer Stage at Diagnosis by Ethnicity, Insurance Status, and Family Income in Young Women in the USA

Franzoi, Maria Alice; Schwartsmann, Gilberto; Azevedo, Sérgio Jobim; Geib, Guilherme; Zaffaroni, Facundo; Liedke, Pedro Emanuel Rubini

doi:10.1007/s40615-019-00591-y

Cited by 26 publications

(23 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although insurance status, address and socioeconomic status have been shown in large SEER studies to be significant predictors of breast cancer outcomes, type of insurance and place of residence were not associated with outcome in the present study. Differences in socioeconomic status between the two groups were likely to be small in this study, as all women were insured.…”

Section: Discussioncontrasting

confidence: 85%

Breast cancer in young black women

Walsh

Zabor

Flynn

et al. 2020

British Journal of Surgery

View full text Add to dashboard Cite

Background: Young age at breast cancer diagnosis is associated with negative prognostic outcomes, and breast cancer in black women often manifests at a young age. This study evaluated the effect of age on breast cancer management and outcomes in black women. Methods:This was a retrospective cohort study of all black women treated for invasive breast cancer between 2005 and 2010 at a specialized tertiary-care cancer centre. Clinical and treatment characteristics were compared by age. Kaplan-Meier methodology was used to estimate overall survival (OS) and disease-free survival (DFS).Results: A total of 666 black women were identified. Median BMI was 30 (range 17-56) kg/m 2 and median tumour size was 16 (1-155) mm. Most tumours were oestrogen receptor-positive (66⋅4 per cent). Women were stratified by age: less than 40 years (74, 11⋅1 per cent) versus 40 years or more (592, 88⋅9 per cent). Younger women were significantly more likely to have a mastectomy, axillary lymph node dissection and to receive chemotherapy, and were more likely to have lymphovascular invasion and positive lymph nodes, than older women. The 5-year OS rate was 88⋅0 (95 per cent c.i. 86⋅0 to 91⋅0) per cent and the 5-year DFS rate was 82⋅0 (79⋅0 to 85⋅0) per cent. There was no statistically significant difference in OS by age (P = 0⋅236). Although DFS was inferior in younger women on univariable analysis (71 versus 88 per cent; P < 0⋅001), no association was found with age on multivariable analysis. Conclusion: Young black women with breast cancer had more adverse pathological factors, received more aggressive treatment, and had worse DFS on univariable analysis. Young age at diagnosis was, however, not an independent predictor of outcome.

show abstract

Section: Discussioncontrasting

confidence: 85%

Breast cancer in young black women

Walsh

Zabor

Flynn

et al. 2020

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Finally, in concordance with the current literature, the Hispanic group had significantly more uninsured 36,44 patients than any other race. This may be attributed to fear due to residency status, the language barrier, or other general lack of understanding of the process to sign up for government insurance.…”

Section: Discussionsupporting

confidence: 89%

“…Regarding stage of diagnosis between different races, less Hispanics were diagnosed with stage I lesions than white women, supporting prior studies reporting later stages at diagnosis for Hispanic 25,36 women.…”

Section: Discussionsupporting

confidence: 80%

Breast Cancer Prevalence and Management in Hispanic Women: Comparison to Black and White Women at a Regional Medical Center

et al. 2021

View full text Add to dashboard Cite

Background: While stage and grade of breast cancer determines prognosis and outcome, race also impacts survival. While Black and White women have been studied, data for Hispanic women is sparse. Methods: Age-matched Hispanic, Black and White women diagnosed/treated with breast cancer at a single institution were retrospectively evaluated regarding prevalence, treatments and outcomes. Results: Overall, 120 women were included in the study (40 per race). No demographic/histologic variables were significantly different among races. ER+/PR+ tumors were less frequent in Hispanics than Whites, but higher than Blacks. Prevalence of triple negative breast cancers in Hispanic women was between the Black and White cohorts (p=0.025 and p=0.011, respectively). Stage II and III diagnoses (p=0.025) were more frequent in Hispanics and they opted for chemotherapy more often (p=0.034); however, there were no significant differences in outcomes and mortality among groups. When compared to the State tumor registry, our population had more LCIS diagnoses (p=0.01), earlier stages (I p=0.02; II p=0.006), received more treatment overall (radiation p=0.02, chemotherapy p=0.0001) and experienced better survival (p=0.004). In comparing the study population to the SEER database, higher rates of LCIS and IDC and lower rates of ILC and mixed histology in the study population were noted. LCIS and IDC were more prevalent in our cohort than SEER data (p=0.005, p=0.05, respectively), although we noted less ILC and mixed histology (p=0.03 and p=0.04). Conclusion: These data are the first reported for Hispanics in our state and highlight the need for larger studies to better serve this growing demographic.

show abstract

“…Numerous prior studies have described the reduced health care utilization rates and cancer outcomes for racial/ethnic minority populations and for patients with Medicaid or no insurance (M/NI). [4][5][6][7][8][9][10][11] In addition, differences in survival by age and sex for many cancers have been clearly characterized. 12 Yet the generalizability of the treatment effects to these subgroups is often assumed, and few, if any, distinctions within demographic or socioeconomic subgroups are made in cancer treatment guidelines.…”

Section: Introductionmentioning

confidence: 99%

Association of Patient Demographic Characteristics and Insurance Status With Survival in Cancer Randomized Clinical Trials With Positive Findings

et al. 2020

View full text Add to dashboard Cite

IMPORTANCE Few new treatments tested in phase 3 cancer randomized clinical trials show an overall survival benefit. Although understanding whether the benefits are consistent among all patient groups is critical for informing guideline care, individual trials are designed to assess the benefits of experimental treatments among all patients and are too small to reliably determine whether treatment benefits apply to demographic or insurance subgroups. OBJECTIVE To systematically examine whether positive treatment effects in cancer randomized clinical trials apply to specific demographic or insurance subgroups. DESIGN, SETTING, AND PARTICIPANTS Cohort study of pooled patient-level data from 10 804 patients in SWOG Cancer Research Network clinical treatment trials reported from 1985 onward with superior overall survival for those receiving experimental treatment. Patients were enrolled from 1984 to 2012. Maximum follow-up was 5 years. MAIN OUTCOMES AND MEASURES Interaction tests were used to assess whether hazard ratios (HRs) for death comparing standard group vs experimental group treatments were associated with age (Ն65 vs <65 years), race/ethnicity (minority vs nonminority populations), sex, or insurance status among patients younger than 65 years (Medicaid or no insurance vs private insurance) in multivariable Cox regression frailty models. Progression-or relapse-free survival was also examined. Data analyses were conducted from August 2019 to February 2020. RESULTS In total, 19 trials including 10 804 patients were identified that reported superior overall survival for patients randomized to experimental treatment. Patients were predominantly younger than 65 years (67.3%) and female (66.3%); 11.4% were black patients, and 5.7% were Hispanic patients. There was evidence of added survival benefits associated with receipt of experimental therapy for all groups except for patients with Medicaid or no insurance (HR, 1.23; 95% CI, 0.97-1.56;

show abstract

Differences in Breast Cancer Stage at Diagnosis by Ethnicity, Insurance Status, and Family Income in Young Women in the USA

Cited by 26 publications

References 32 publications

Breast cancer in young black women

Breast cancer in young black women

Breast Cancer Prevalence and Management in Hispanic Women: Comparison to Black and White Women at a Regional Medical Center

Association of Patient Demographic Characteristics and Insurance Status With Survival in Cancer Randomized Clinical Trials With Positive Findings

Contact Info

Product

Resources

About