Race as an Independent Risk Factor for Breast Cancer Survival: Breast Cancer Outcomes From the Medical College of Georgia Tumor Registry |
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| Authors: | Carlos H Barcenas Jeremy Wells Daniel Chong John French Stephen W Looney Thomas A Samuel |
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| Institution: | 1. Deparment of Medicine, Section of Hematology/Oncology, Medical College of Georgia, Augusta;2. Department of Biostatistics, Medical College of Georgia, Augusta;1. Department of Radiology, Box 357115, 1959 NE Pacific Street, University of Washington, Seattle, WA 98195, USA;2. Department of Bioengineering, University of Washington, William H. Foege Building, N510B, 3720 15th Ave NE, Seattle, WA 98195-5061, USA;3. Department of Bioengineering, University of Washington, Box 355061, Seattle, WA 98195-5061, USA;1. Adult Cancer Program, Prince of Wales Clinical School, University of New South Wales, NSW, Australia;2. Faculty of Pharmacy, University of Sydney, NSW, Australia;3. National Centre for Epidemiology and Population Health, Australian National University, ACT, Australia;4. Cancer Epidemiology and Services Research, Sydney School of Public Health, Sydney Medical School, University of Sydney, NSW, Australia;5. Sydney Medical School, School of Public Health, University of Sydney, NSW, Australia;1. Department of Surgery, Yale University School of Medicine, New Haven CT 06520 USA;2. Department of Surgery, Section of Endocrine Surgery, Duke University School of Medicine, Durham NC 27710 USA;1. Department of Structural Engineering, University of California, San Diego La Jolla, CA, 92093-0085, USA;2. Dipartimento di Ingegneria Strutturale e Geotecnica, Sapienza Università di Roma, Rome, Italy |
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| Abstract: | BackgroundCauses of racial disparities in breast cancer survival remain unclear. This study assesses overall survival (OS) after diagnosis between black and white women and examines factors that might correlate with this disparity.Patients and MethodsData were obtained from the Medical College of Georgia Tumor Registry. Cases included those diagnosed between 1990 and 2005. We analyzed race, stage, age of diagnosis, and treatment received: chemotherapy, radiation, surgery, and hormonal therapy. A Cox proportional hazards model was used to determine differences in OS.ResultsCompared with 670 white women, 489 black women were more likely to be younger, have later-stage disease at diagnosis, and were less likely to have received hormonal therapy. Both groups received similar rates of radiation, surgery, and chemotherapy. Black women had significantly poorer OS (adjusted hazard ratio, 1.35; 95% CI, 1.12–1.63). White women had a 5-year OS of 54% compared with 45% in black women (P = .0031). Having received radiation, surgery, or chemotherapy was not associated with OS. White women were more likely to have received hormonal therapy, which had a significant protective effect. However, a stratified analysis (between those who received hormonal therapy and those who did not) showed similar results, whereas black women experienced poorer OS in both strata.ConclusionBlack women with breast cancer had a significantly poorer OS compared with white women. White women received more hormonal therapy, which had a protective effect. There were no differences in treatment received regarding radiation, surgery, or chemotherapy, and these treatments were not associated with OS. The reasons for racial disparities in breast cancer OS remain complex. |
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