Breast Cancer Survival Varies by Race, Ethnicity, Study Shows
Some, but not all, differences persist after taking socioeconomic status into account
Tuesday, October 30, 2012
However, in some cases, those factors did affect the rate of survival, according to the study.
"The worse survival for African Americans disappeared after adjusting for socioeconomic status and other lifestyle factors," said study author Salma Shariff-Marco, a research scientist at the Cancer Prevention Institute of California, in Fremont.
"There was an effect of neighborhood socioeconomic status associated with survival, with increasing neighborhood socioeconomic status associated with better survival," she said.
Shariff-Marco were scheduled to present the findings Tuesday at the annual cancer prevention conference of the American Association for Cancer Research, in San Diego.
Previous breast cancer research has consistently shown the worst survival rates for black women, and white women have the next highest mortality rates. Hispanics and Asians typically have the lowest mortality rates.
Experts have debated what factors might be responsible for these differences, but two factors that are always suspect are socioeconomic status and education.
To see if racial differences would remain after adjusting for these factors, Shariff-Marco and her colleagues reviewed data on 4,405 women diagnosed with breast cancer between 1995 and 2008.
There were 1,068 whites, 1,670 Hispanics, 993 blacks and 674 Asian Americans in the study. The women were all from the San Francisco Bay area.
When they looked at the unadjusted data, researchers found that survival rates were the worst for blacks, and the best for Hispanics and Asians compared to whites.
But, when they adjusted for treatment and other lifestyle factors, blacks had an improved survival rate, similar to that of white women. When the researchers applied these same adjustment factors to Hispanic and Asian women, their survival remained above that of black and white women.
The researchers also found that neighborhood socioeconomic status seemed to play a role. Compared to whites with more education and a high neighborhood socioeconomic status, blacks had worse survival, regardless of their own education level, if they lived in a poorer neighborhood.
Hispanics living in wealthier neighborhoods, regardless of their own education level, had better survival than well-educated whites living in wealthier areas. The same was true for Asian women, except that their education level seemed to matter in their improved survival.
Shariff-Marco said it's not clear why the neighborhood characteristics seem to be so important, often even more important than a person's own education.
"We need to dig a little deeper to understand what the socioeconomic status contributes to survival. Our findings speak to a greater need to understand what is contributing to better and worse health in some neighborhoods," she said.
Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, said that "part of the problem with treating this disease is that only some people have access to care."
It also may be that breast cancer may need to be treated differently in each ethnic group, Bernik said.
Study author Shariff-Marco said while resources exist, some may be underused.
"Women need to be aware of resources that are available to women for treatment and survival," she advised. "Breast cancer patients should be aware of support groups and patient navigation programs that help them get into the care they need."
Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.
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