Impact of Sociodemographic Factors on Racial/Ethnic Differences in Tumor Stage and Size for Cancer of the Female Breast
Uniformed Services University Of The Health Sciences Bethesda United States
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A population-based, case-control study was conducted to determine the importance of sociodemographic factors in explaining racialethnic differences in tumorstage and size at the time of diagnosis among women with invasive, primary breast cancer. The study group included 106,607 women newly diagnosed with breast cancer during the years 1992 through 1996 while residing in any of the eleven reporting areas in the United States that comprise the Surveillance, Epidemiology, and End Results SEER program of the National Cancer Institute NCI. Descriptive tabulations of the study variables indicated that Japanese and White women tended to be diagnosed at an earlier stage, with smaller diameter tumors, and at a lower tumor grade than other groups. Black and Hispanic women were more likely than other groups to be diagnosed with metastatic disease, with tumors 2 cm or larger in diameter, and with poorly differentiated tumors. In the regression analysis, elevated odds ratios among Black and Hispanic patients for later stage and larger size tumors were reduced by 50 to 60 when sociodemographic factors were added to a model already containing age and geographic area. Tumor grade and hormone receptor status only explained a small amount of the excess odds for distant stage disease among Black and Hispanic women, and did not explain any of the racialethnic differences in regional stage disease or larger tumor size. In the analysis of tumor size, odds ratios for Black, Hispanic, Filipino, Chinese, and Korean women remained elevated relative to White women after adjustment for sociodemographic factors, tumor grade, and hormone receptor status. Japanese women, conversely, had consistently lower odds ratios relative to White women for every study outcome.
- Medicine and Medical Research
- Sociology and Law
- Statistics and Probability