Impact of Treatment and Socioeconomic Status on Racial Disparities in Survival Among Older Women With Breast Cancer

Abstract

Racial disparities in overall survival between African-American and white women with breast cancer were not present after controlling for treatment and socioeconomic status. Efforts to eliminate these barriers have important public health implications for reducing disparities in health outcomes.

A population based study of variations in operation rates for breast cancer, of comorbidity and prognosis at diagnosis: Failure to operate for early breast cancer in older women

“…9 The question that remains unanswered is whether they are disadvantaged mainly on the basis of their age or whether individual circumstances including patient choice indicate that conservative management may be in their best interests. Women of lower socioeconomic status or of certain ethnic origins 10,11 may be particularly at risk of suboptimal treatment outcomes and there is increasing evidence that comorbidity has to be considered in the multidisciplinary management of patients. 12 The simple proportional values for no surgery for those under age 50 shown in Fig.…”

Comorbidities and Their Management: Potential Impact on Breast Cancer Outcomes

“…These fi ndings reported in the 2014 Annual Report to the Nation on the Status of Cancer (Edwards et al 2013 ) underscore previous fi ndings that breast cancer patients with one or more comorbidities are at substantially increased risk of death from competing causes and at modestly increased risk of breast cancer specifi c death (Sogaard et al 2013 ;Patnaik et al 2011b ;Land et al 2012a , b ;Berglund et al 2012 ;Bush et al 2011 ), and that breast cancer survivors who are most likely to be impacted by comorbidities are women with early stage breast cancer who have high other cause mortality, who have shown little or modest improvements in breast cancer specifi c mortality over time (Edwards et al 2013 ;Cronin-Fenton et al 2007 ;Land et al 2012a ;Izano et al 2014 ). Findings from over 15 retrospective cohort studies (Cronin-Fenton et al 2007 ;Tammemagi et al 2005 ;Yancik et al 2001a ;Schonberg et al 2010 ;Carlsen et al 2008 ;Dalton et al 2007 ;JanssenHeijnen et al 2005 ;Louwman et al 2005, Houterman et al 2004Nagel et al 2004 ;Maskarinec et al 2003 ;Du et al 2008 ;Harris et al 2008 ;McPherson et al 2002 ;Siegelmann-Danieli et al 2006 ) suggest that comorbidity increases risk of competing cause mortality by up to sixfold, while breast cancer specifi c mortality is increased by 20-50 % (Patnaik et al 2011a ;Berglund et al 2012 ;Schonberg et al 2010 ;Dalton et al 2007 ;Du et al 2008 ), although some studies have failed to observe differences in breast cancer recurrence or survival (Tammemagi et al 2005 ;Braithwaite et al 2012 ;…”

Investigating reasons for ethnic inequalities in breast cancer survival in New Zealand

“…Previous research has described survival differences between indigenous Māori and non-Māori New Zealanders (Jeffreys et al 2005, Robson et al 2006. Other evidence of differential survival between ethnic groups has primarily arisen from the United States, where African American women have poorer survival than White women (O'Malley et al 2003, Curtis et al 2008, Du et al 2008. In other countries, ethnic differences have also been found, with lower survival in Indigenous compared to White Australians (Spilsbury et al 2005) and better survival in South Asian and Chinese compared to other women in the UK (Dos Santos Silva et al 2003, Velikova et al 2004, Jack et al 2009.…”