Description
Breast cancer (BC) is the most common cancer and the second leading cause of cancer-related deaths in women. However, a disproportionate number of BC deaths occur among minorities. To date, the majority of BC disparity studies have focused on African- American women. Fewer have looked directly at BC survival in US Hispanics and of these studies, the vast majority report Hispanics as an aggregate group. This, of course, is a major limitation possibly masking importance differences in Hispanic subpopulations. Cancer-specific and all-cause survival rates were analyzed for 273,357 non-Hispanic White (NHW) women and 5 ethnic Hispanic subpopulations diagnosed between 2000 and 2006 and followed through the end of 2009, using Surveillance, Epidemiology and End Results (SEER) data. NHW women had the highest percentage diagnosed at the earliest stage (47.1%) while Mexican and Cuban women had the highest percentage diagnosed at stage III (16.0%) and stage IV (6.5%), respectively. Five-year all-cause survival was highest among South-Central American women (81%), followed by NHW women (76%) and lowest among Puerto Rican women (62%) (p < 0.001). After adjusting for age, year diagnosed, US region, stage, grade, and SES (composite variable of county level poverty and percent with high school degree), Mexican and Puerto Rican women had significantly higher hazard ratios (1.32 and 1.87, respectively) of cancer-specific death compared to NHW women (p < 0.0001). Despite improvement in BC survival rates ethnic differences persist. Stage, grade, and SES helped explain some of the disparities. Specific targeted interventions to increase screening and greater treatment coverage may help reduce disparities in BC survival.
