A Five-Year Breast Cancer-Specific Survival Disadvantage of African American Women
), Franklin Opara(2), Jobayer Hossain(3),
(1)
(2)
(3)
Corresponding Author
Abstract
Racial/ethnic disparities in female breast cancer survival continue to persist in United States. However, disparities comparing African Americans (AA), Asians and Caucasians remain to be assessed. We aimed to assess multiracial/ethnic disparities in breast cancer survival, and to examine the factors that may explain the variability. A total of 6,951 women diagnosed with breast cancer between 1992 and 1998 were identified from Surveillance, Epidemiology, and End Results tumor registries. The effect of race/ethnicity and the prognostic factors on survival was assessed using Cox proportional hazard model. AA demonstrated a survival disadvantage. Compared to Asians, Caucasians had 74% increased risk of dying (HR= 1.74, 95% CI = 1.31 – 2.33), while AA were almost three times as likely as Asians to die, (HR=2.78, 95% CI 2.02 – 3.86). After adjustment for the relevant covariates the survival disadvantage of AA persisted. Relative to Asians, Caucasians were 45% more likely to die (HR=1.45, 95% CI 1.10 – 1.93), while AA were more than two times as likely to die (HR=2.57, 95% CI 1.86 - 3.55). There were substantial racial/ethnic disparities in breast cancer survival among United States women. AA demonstrated survival disadvantage compared with either Caucasians or Asians, which persisted even after controlling factors known to influence breast cancer survival (Afr. J. Reprod. Health 2010; 14[3]: 195-200).
Résumé
Désavantage de la survie spécifique du cancer du sein à cinq ans chez les femmes afro-américaines. Les disparités raciales/ethniques dans la survie du cancer du sein chez la femme persistent encore aux Etats-Unis. Néanmoins, l’on n’a pas encore évalué les disparités de manière comparative chez les Afro-Américains (AA), les Asiatiques et les Caucasiens. Nous avions comme objectif d’avancer les disparités dans la survie du cancer du sein et d’examiner les facteurs qui puissent expliquer la variabilité. Au total, on a diagnostiqué le cancer du sein chez 6951 femmes entre 1992 et 1998 qui ont été identifiées à travers la surveillance, l’épidémiologie et des listes des résultats définitifs de la tumeur. L’effet de la race / l’ethnie et les facteurs pronostiqués sur la survie ont été évalués à l’aide du modèle du danger proportionnel de Cox. L’AA a démontré un désavantage de la survie. Par rapport aux Asiatiques, les Caucasiens couraient un risque accru à74% de mourir (HR1, 74, 95% Cl = 1,31-2,33), alors que les AA avaient presque trois fois plus la possibilité de mourir que les Asiatiques (HR=2,78, 95%Cl 2,92-3,86). Après les ajustements pour arriver aux co-variables, le désavantage de la survie de l’AA a persisté. Par rapport aux Asiatiques, les Caucasiens avaient 45% plus la possibilité de mourir (HR=1,45, 95% CL 110-1,93), tandis que les AA avaient plus de deux fois la possibilité de mourir (HR=2,57, 95%CL 1,86-3,55). Il y avait beaucoup de disparités raciales/ethniques à l’égard de la survie du cancer du sein chez les femmes américaines. Les AA ont démontré un désavantage de la survie par rapport soit aux Caucasiens soit aux Asiatiques qui ont persisté même après avoir contrôlé les facteurs qui influent sur la survie du cancer du sein (Afr. J. Reprod. Health 2010; 14[3]: 195-200).
Key words: African American Women; breast cancer survival; racial/ethnic disparities; United States.
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