Disparities in survival after breast cancer persisted across racial and ethnic groups even after researchers adjusted for multiple demographics that included patients’ education and the socioeconomic status of the neighborhood where they lived.
The researchers studied data from 4,405 patients with breast cancer who had participated in one of two population-based studies undertaken in the San Francisco Bay Area. The participants included 1,068 non-Latina whites, 1,670 Latinas, 993 African Americans, and 674 Asian Americans.
All-cause survival was worse for African Americans and better for Latinas and Asian Americans compared with non-Latina whites after adjusting for age, study, and tumor characteristics. When the researchers added adjustments for treatment, reproductive factors, and lifestyle factors, African Americans were found to have survival rates similar to non-Latina whites, but the survival rates remained better for Latinas and Asian Americans.
The researchers also evaluated disparities in survival while considering racial, ethnic, and socioeconomic status interactions. Compared with non-Latina whites with high education and high neighborhood socioeconomic status, worse survival occurred for African Americans with low neighborhood socioeconomic status, regardless of education, and better survival occurred among Latinas with high neighborhood socioeconomic status, regardless of education, and among Asian Americans with high education and high neighborhood socioeconomic status.
The research group explained that certain groups who were identified as having better or worse survival would benefit from further study to understand their risk profiles and target specific interventions.
“Understanding and addressing potential barriers to better survival are needed for groups with worse survival,” said Salma Shariff-Marco, PhD, MPH, of the Cancer Prevention Institute of California in Fremont. “One program that may be useful is patient navigation to ensure that these women are able to access and navigate the health care system. Sharing these findings with the broader public health community (eg, health educators, community-based organizations, and leaders) will also be helpful.”
This research was presented at the Fifth American Association for Cancer Research conference on The Science of Cancer Health Disparities in San Diego, California.