© 1999 by Oxford University Press
Journal of the National Cancer Institute, Vol. 91, No. 17, 1487-1491,
September 1, 1999
© 1999 Oxford University Press
REPORTS |
Race and Differences in Breast Cancer Survival in a Managed Care Population
Affiliations of authors: M. Ulcickas Yood, Josephine Ford Cancer Center and Center for Clinical Effectiveness, Henry Ford Health Sciences Center, Detroit, MI, and Bristol-Myers Squibb, Wallingford, CT; C. C. Johnson, J. Abrams (Josephine Ford Cancer Center and Department of Biostatistics and Research Epidemiology), A. Blount (Josephine Ford Cancer Center), B. D. McCarthy (Center for Clinical Effectiveness), U. Raju, M. Worsham, (Josephine Ford Cancer Center and Department of Pathology), D. S. Nathanson (Josephine Ford Cancer Center, and Department of Surgery), Henry Ford Health Sciences Center; E. Wolman, Department of Systems Engineering and Operations Research, George Mason University, Fairfax, VA; S. R. Wolman, Department of Pathology, Uniformed Services University of the Health Sciences, Bethesda, MD.
Correspondence to: Marianne Ulcickas Yood, D.Sc., M.P.H., Josephine Ford Cancer Center, 1 Ford Place, 5C, Detroit, MI 48202 (e-mail: ulcickam{at}bms.com).
BACKGROUND: African-American women with breast cancer have poorer survival than European-American women. After adjustment for socioeconomic variables, survival differences diminish but do not disappear, possibly because of residual differences in health care access, biology, or behavior. This study compared breast cancer survival in African-American and European-American women with similar health care access. METHODS: We measured survival in women with breast cancer who are served by a large medical group and a metropolitan Detroit health maintenance organization where screening, diagnosis, treatment, and follow-up are based on standard practices and mammography is a covered benefit. We abstracted data on African-American and European-American women who had been diagnosed with breast cancer from January 1986 through April 1996 (n = 886) and followed these women for survival through April 1997 (137 deaths). RESULTS: African-American women were diagnosed at a later stage than were European-American women. Median follow-up was 50 months. Five-year survival was 77% for African-American and 84% for European-American women. The crude hazard ratio for African-American women relative to European-American women was 1.6 (95% confidence interval [CI] = 1.1-2.2). Adjusting only for stage, the hazard ratio was 1.3 (95% CI = 0.9-1.9). Adjusting only for sociodemographic factors (age, marital status, and income), the hazard ratio was 1.2 (95% CI = 0.8-1.9). After adjusting for age, marital status, income, and stage, the hazard ratio was 1.0 (95% CI = 0.7-1.5). CONCLUSION: Among women with similar medical care access since before their diagnoses, we found ethnic differences in stage of breast cancer at diagnosis. Adjustment for this difference and for income, age, and marital status resulted in a negligible effect of race on survival.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. N. Cormier, Y. Xing, M. Ding, J. E. Lee, P. F. Mansfield, J. E. Gershenwald, M. I. Ross, and X. L. Du Ethnic differences among patients with cutaneous melanoma. Arch Intern Med, September 25, 2006; 166(17): 1907 - 1914. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Kimmick, F. Camacho, K. L. Foley, E. A. Levine, R. Balkrishnan, and R. Anderson Racial Differences in Patterns of Care Among Medicaid-Enrolled Patients With Breast Cancer J. Oncol. Pract, September 1, 2006; 2(5): 205 - 213. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Amend, D. Hicks, and C. B. Ambrosone Breast Cancer in African-American Women: Differences in Tumor Biology from European-American Women. Cancer Res., September 1, 2006; 66(17): 8327 - 8330. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Blackman and C. M. Masi Racial and Ethnic Disparities in Breast Cancer Mortality: Are We Doing Enough to Address the Root Causes? J. Clin. Oncol., May 10, 2006; 24(14): 2170 - 2178. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Smith-Bindman, D. L. Miglioretti, N. Lurie, L. Abraham, R. B. Barbash, J. Strzelczyk, M. Dignan, W. E. Barlow, C. M. Beasley, and K. Kerlikowske Does utilization of screening mammography explain racial and ethnic differences in breast cancer? Ann Intern Med, April 18, 2006; 144(8): 541 - 553. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. A. Newman, K. A. Griffith, I. Jatoi, M. S. Simon, J. P. Crowe, and G. A. Colditz Meta-Analysis of Survival in African American and White American Patients With Breast Cancer: Ethnicity Compared With Socioeconomic Status J. Clin. Oncol., March 20, 2006; 24(9): 1342 - 1349. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. T. Chlebowski, R. Prentice, and L. L. Adams-Campbell RESPONSE: Re: Ethnicity and Breast Cancer: Factors Influencing Differences in Incidence and Outcome J Natl Cancer Inst, November 2, 2005; 97(21): 1619 - 1620. [Full Text] [PDF]
|
|
|
|
 |
|
 T. S. Field, D. S. M. Buist, C. Doubeni, S. Enger, H. Fouayzi, G. Hart, E. J. Korner, L. Lamerato, D. J. Bachman, J. Ellis, et al. Disparities and Survival Among Breast Cancer Patients J Natl Cancer Inst Monographs, November 1, 2005; 2005(35): 88 - 95. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. M. Tammemagi, D. Nerenz, C. Neslund-Dudas, C. Feldkamp, and D. Nathanson Comorbidity and Survival Disparities Among Black and White Patients With Breast Cancer JAMA, October 12, 2005; 294(14): 1765 - 1772. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. W. Hance, W. F. Anderson, S. S. Devesa, H. A. Young, and P. H. Levine Trends in Inflammatory Breast Carcinoma Incidence and Survival: The Surveillance, Epidemiology, and End Results Program at the National Cancer Institute J Natl Cancer Inst, July 6, 2005; 97(13): 966 - 975. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Farooq and M. P Coleman Breast cancer survival in South Asian women in England and Wales J. Epidemiol. Community Health, May 1, 2005; 59(5): 402 - 406. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. T. Chlebowski, Z. Chen, G. L. Anderson, T. Rohan, A. Aragaki, D. Lane, N. C. Dolan, E. D. Paskett, A. McTiernan, F. A. Hubbell, et al. Ethnicity and Breast Cancer: Factors Influencing Differences in Incidence and Outcome J Natl Cancer Inst, March 16, 2005; 97(6): 439 - 448. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. A. Newman Breast Cancer in African-American Women Oncologist, January 1, 2005; 10(1): 1 - 14. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. W. Brawley The Study of Accrual to Clinical Trials: Can We Learn From Studying Who Enters Our Studies? J. Clin. Oncol., June 1, 2004; 22(11): 2039 - 2040. [Full Text] [PDF]
|
|
|
|
|
|
D. S. Serna, S. J. Lee, M.-j. Zhang, K. S. Baker, M. Eapen, M. M. Horowitz, J. P. Klein, J. D. Rizzo, and F. R. Loberiza Jr Trends in Survival Rates After Allogeneic Hematopoietic Stem-Cell Transplantation for Acute and Chronic Leukemia by Ethnicity in the United States and Canada J. Clin. Oncol., October 15, 2003; 21(20): 3754 - 3760. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. I. Li, K. E. Malone, and J. R. Daling Differences in Breast Cancer Stage, Treatment, and Survival by Race and Ethnicity Arch Intern Med, January 13, 2003; 163(1): 49 - 56. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. X. Clegg, F. P. Li, B. F. Hankey, K. Chu, and B. K. Edwards Cancer Survival Among US Whites and Minorities: A SEER (Surveillance, Epidemiology, and End Results) Program Population-Based Study Arch Intern Med, September 23, 2002; 162(17): 1985 - 1993. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. I. Li, K. E. Malone, and J. R. Daling Differences in Breast Cancer Hormone Receptor Status and Histology by Race and Ethnicity among Women 50 Years of Age and Older Cancer Epidemiol. Biomarkers Prev., July 1, 2002; 11(7): 601 - 607. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. B. Bach, D. Schrag, O. W. Brawley, A. Galaznik, S. Yakren, and C. B. Begg Survival of Blacks and Whites After a Cancer Diagnosis JAMA, April 24, 2002; 287(16): 2106 - 2113. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. W. Brawley Disaggregating the Effects of Race and Poverty on Breast Cancer Outcomes J Natl Cancer Inst, April 3, 2002; 94(7): 471 - 473. [Full Text] [PDF]
|
|
|
|
|
|
C. J. Bradley, C. W. Given, and C. Roberts Race, Socioeconomic Status, and Breast Cancer Treatment and Survival J Natl Cancer Inst, April 3, 2002; 94(7): 490 - 496. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Earp, E. Eng, M. S. O'Malley, M. Altpeter, G. Rauscher, L. Mayne, H. F. Mathews, K. S. Lynch, and B. Qaqish Increasing Use of Mammography Among Older, Rural African American Women: Results From a Community Trial Am J Public Health, April 1, 2002; 92(4): 646 - 654. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. C. Schneider, A. M. Zaslavsky, and A. M. Epstein Racial Disparities in the Quality of Care for Enrollees in Medicare Managed Care JAMA, March 13, 2002; 287(10): 1288 - 1294. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. Dignam Efficacy of Systemic Adjuvant Therapy for Breast Cancer in African-American and Caucasian Women J Natl Cancer Inst Monographs, December 1, 2001; 2001(30): 36 - 43. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. I. Harris Racial and Ethnic Differences in Health Care Access and Health Outcomes for Adults With Type 2 Diabetes Diabetes Care, March 1, 2001; 24(3): 454 - 459. [Abstract] [Full Text]
|
|
|
|
|
|
C. Dunmore, P. Plummer, G. Regan, D. Mattingly, S. Jackson, and R. Millikan Re: Race and Differences in Breast Cancer Survival in a Managed Care Population J Natl Cancer Inst, October 18, 2000; 92(20): 1690 - 1691. [Full Text] [PDF]
|
|