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Method of detection and breast cancer survival disparities in Hispanic women.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Hill, Deirdre A. Nibbe, Andrea Royce, Melanie E. Wallace, Anne Marie Kang, Huining Wiggins, Charles L. Rosenberg, Robert D.
Spatial Coverage	New Mexico
Description	Country affiliation: United States Author Affiliation: Hill DA ( University of New Mexico Cancer Research and Treatment Center and Department of Internal Medicine, MSC 10 5550, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA. dahill@salud.unm.edu)
Abstract	BACKGROUND: Hispanic women in New Mexico (NM) are more likely than non-Hispanic women to die of breast cancer-related causes. We determined whether survival differences between Hispanic and non-Hispanic women might be attributable to the method of detection, an independent breast cancer prognostic factor in previous studies. METHODS: White women diagnosed with invasive breast cancer from 1995 through 2004 were identified from NM Surveillance Epidemiology End Results (SEER) files (n = 5,067) and matched to NM Mammography Project records. Method of cancer detection was categorized as 'symptomatic' or 'screen-detected.' The proportion of Hispanic survival disparity accounted for by included variables was assessed using Cox models. RESULTS: In the median follow-up of 87 months, 490 breast cancer deaths occurred. Symptomatic versus screen-detection was classifiable for 3,891 women (76.8%), and was independently related to breast cancer-specific survival [hazard ratio (HR), 1.6; 95% confidence interval (95% CI), 1.3-2.0]. Hispanic women had a 1.5-fold increased risk of breast cancer-related death, relative to non-Hispanic women (95% CI, 1.2-1.8). After adjustment for detection method, the Hispanic HR declined from 1.50 to 1.45 (10%), but after inclusion of other prognostic indicators the Hispanic HR equaled 1.23 (95% CI, 1.01-1.48). CONCLUSIONS: Although the Hispanic HR declined 50% after adjustment, the decrease was largely due to adverse tumor prognostic characteristics. IMPACT: Reduction of disparate survival in Hispanic women may rely not only on increased detection of tumors when asymptomatic but on the development of greater understanding of biological factors that predispose to poor prognosis tumors.
File Format	HTM / HTML
ISSN	10559965
e-ISSN	15387755
DOI	10.1158/1055-9965.EPI-10-0164
Journal	Cancer Epidemiology Biomarkers & Prevention
Issue Number	10
Volume Number	19
Language	English
Publisher	American Association for Cancer Research
Publisher Date	2010-10-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Cancer epidemiology Breast Neoplasms Diagnosis Ethnology Health Status Disparities Hispanic Americans Statistics & Numerical Data Mortality Pathology Cohort Studies European Continental Ancestry Group Neoplasm Staging New Mexico Epidemiology Prognosis Proportional Hazards Models Risk Factors Survival Rate Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Epidemiology Oncology

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