Influence of birthplace on breast cancer diagnosis and treatment for Hispanic women

Kouri, Elena M.; He, Yulei; Winer, Eric P.; Keating, Nancy L.

doi:10.1007/s10549-009-0643-3

Cited by 37 publications

(27 citation statements)

References 55 publications

(61 reference statements)

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“…Social and cultural barriers, like “fear to be left by her partner, poor awareness of the population and primary health providers, as well as deficient mammographic screening programs,” could lead to an advanced stage at diagnosis 4. Hispanic women have been found to have a 1.7- to 2.5-fold elevation in the risk of stages III and IV tumors, compared to non-Hispanic whites 2–6,14. Warner et al3 found Hispanic and other minority women were more likely to show up with cancer symptoms versus a problem detected through screening mammography, and experienced longer times from initial signs of cancer to final diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Breast Cancer Characteristics and Survival in a Hispanic Population of Costa Rica

Srur-Rivero

Cartín-Brenes

2014

Breast Cancer�(Auckl)

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BACKGROUNDBreast cancer characteristics may vary according to the patient’s ethnic group. The goal of this cohort study was to evaluate the characteristics of a group of Costa Rican breast cancer patients and their relationship with survival.METHODSAge, stage, tumor grade, immunohistochemistry, lymphovascular invasion, recurrence, and survival data on 199 Hispanic patients with breast cancer diagnosis, treated between January 2009 and May 2010, were collected from a single institution in San Jose, Costa Rica. The data were statistically analyzed for significance.RESULTSMedian age at diagnosis was 53 years. With a median follow-up of 46.5 months, there was an 88% overall survival rate. Thirty-seven percent of the patients (p < 0.001) were at stages III and IV during diagnosis. The hormone receptor human epidermal receptor negative phenotype (HR−HER2−) (p < 0.001) was present in 17% of the cases. In a multivariate analysis, local (risk ratio, RR: 7.2; confidence interval, CI 95%: 3.8–7.6; p = 0.06) and distant recurrence (RR: 14.9; CI 95%: 7.7–28.9; p = 0.01) showed the strongest association with the probability of death from the disease. Patients with HR−HER2− phenotype tumors reported more local recurrences (p = 0.04), a higher tumor grade (p < 0.01), and lower overall survival than patients with other breast cancer phenotypes (p = 0.01).CONCLUSIONSAlthough this study analyzes a modest number of cases, it is an initial insight into factors that may contribute to differences in breast cancer outcomes among Hispanic women in Costa Rica. The higher proportion of triple negative tumors, advanced stage, and younger median age at diagnosis could contribute to the inferior prognostic described among Hispanic women. There may be a different distribution of tumor subtypes compared to non-Hispanic white women. Further studies are necessary to confirm such findings.

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Section: Discussionmentioning

confidence: 99%

Breast Cancer Characteristics and Survival in a Hispanic Population of Costa Rica

Srur-Rivero

Cartín-Brenes

2014

Breast Cancer�(Auckl)

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“…Reduced access to healthcare among foreign-born Hispanic women may result in greater time delay between the date of cancer diagnosis and the date of treatment, as well as the quality of treatment and post-treatment follow-up [45]. While a detailed exploration of potential treatment differences between U.S.- and foreign-born Hispanics is beyond the scope of this manuscript, nativity disparities in cancer treatment have been documented for breast, lung, and colorectal cancer [46, 47], and may exist for cervical cancer. We also cannot rule out other explanations (e.g., characteristics related to human papillomavirus infection) as we rely on variables available in SEER.…”

Section: Discussionmentioning

confidence: 99%

Nativity disparities in late-stage diagnosis and cause-specific survival among Hispanic women with invasive cervical cancer: an analysis of Surveillance, Epidemiology, and End Results data

Montealegre

Zhou

Amirian

et al. 2013

Cancer Causes Control

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Purpose While cervical cancer screening and risk behaviors have been found to vary among U.S.- and foreign-born Hispanic women, many cancer epidemiology studies have conceptualized Hispanics as a homogenous group. Here we examine differences in cervical cancer stage at diagnosis and survival among Hispanic women by nativity. Methods We use data from the Surveillance, Epidemiology, and End Results (SEER) program, 1998–2008. Nativity was based on place of birth and was categorized as U.S.- versus foreign-born. Distant and regional tumors were classified as late-stage, while local tumors were classified as early-stage. Results Forty seven percent of cases of invasive cervical cancer among Hispanics were diagnosed at a late stage and over half of invasive cervical cancer cases were among foreign-born women. Foreign-born Hispanic women were significantly more likely than U.S.-born Hispanics to have late-stage diagnosis, after adjusting for age at diagnosis and tumor histology (adjusted odds ration= 1.09, p-value = 0.003). There was heterogeneity in the association between nativity and survival by stage at diagnosis. Among cases with early-stage diagnosis, survival was poorer among foreign-born versus U.S.-born Hispanics after adjusting for age at diagnosis, histology, and cancer-directed therapy (adjusted HR = 1.31, p-value = 0.030). However, among cases with late-stage diagnosis, survival was better among foreign--born Hispanics (adjusted HR = 0.81, p-value < 0.001). Conclusions We hypothesize that nativity differences in survival may be indicative of diverse risk, screening, and treatment profiles. Given such differences, it may be inappropriate to aggregate Hispanics as a single group for cervical cancer research.

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“…Previous research has shown disparities among US and immigrant populations in cancer information, 4 screening rates, 5–10 early diagnosis, 11 quality of care, 12 receipt of recommended treatment, 11,12 and survival outcomes. 13 Identified barriers to access health services include access to care factors (e.g.…”

Section: Introductionmentioning

confidence: 99%

Addressing cancer control needs of African-born immigrants in the US: A systematic literature review

Hurtado‐de‐Mendoza¹,

Song²,

Kigen³

et al. 2014

Preventive Medicine

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Compared to non-Hispanic Whites, African immigrants have worse cancer outcomes. However, there is little research about cancer behaviors and/or interventions in this growing population as they are generally grouped with populations from America or the Caribbean. This systematic review examines cancer-related studies that included African-born participants. We searched PsychINFO, Ovid Medline, Pubmed, CINHAL, and Web of Science for articles focusing on any type of cancer that included African-born immigrant participants. Twenty articles met study inclusion criteria; only two were interventions. Most articles focused on one type of cancer (n=11) (e.g., breast cancer) and were conducted in disease-free populations (n=15). Studies included African participants mostly from Nigeria (n=8) and Somalia (n=6). However, many papers (n=7) did not specify nationality or had small percentages (<5%) of African immigrants (n=5). Studies found lower screening rates in African immigrants compared to other subpopulations (e.g. US born). Awareness of screening practices was limited. Higher acculturation levels were associated with higher screening rates. Barriers to screening included access (e.g. insurance), pragmatic (e.g. transportation), and psychosocial barriers (e.g. shame). Interventions to improve cancer outcomes in African immigrants are needed. Research that includes larger samples with diverse African subgroups including cancer survivors are necessary to inform future directions.

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Influence of birthplace on breast cancer diagnosis and treatment for Hispanic women

Cited by 37 publications

References 55 publications

Breast Cancer Characteristics and Survival in a Hispanic Population of Costa Rica

Breast Cancer Characteristics and Survival in a Hispanic Population of Costa Rica

Nativity disparities in late-stage diagnosis and cause-specific survival among Hispanic women with invasive cervical cancer: an analysis of Surveillance, Epidemiology, and End Results data

Addressing cancer control needs of African-born immigrants in the US: A systematic literature review

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