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Racial/ethnic and socioeconomic differences in short-term breast cancer survival among women in an integrated health system.
- Author(s): Keegan, Theresa HM
- Kurian, Allison W
- Gali, Kathleen
- Tao, Li
- Lichtensztajn, Daphne Y
- Hershman, Dawn L
- Habel, Laurel A
- Caan, Bette J
- Gomez, Scarlett L
- et al.
Published Web Locationhttps://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2014.302406?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed&
No data is associated with this publication.
ObjectivesWe examined the combined influence of race/ethnicity and neighborhood socioeconomic status (SES) on short-term survival among women with uniform access to health care and treatment.
MethodsUsing electronic medical records data from Kaiser Permanente Northern California linked to data from the California Cancer Registry, we included 6262 women newly diagnosed with invasive breast cancer. We analyzed survival using multivariable Cox proportional hazards regression with follow-up through 2010.
ResultsAfter consideration of tumor stage, subtype, comorbidity, and type of treatment received, non-Hispanic White women living in low-SES neighborhoods (hazard ratio [HR] = 1.28; 95% confidence interval [CI] = 1.07, 1.52) and African Americans regardless of neighborhood SES (high SES: HR = 1.44; 95% CI = 1.01, 2.07; low SES: HR = 1.88; 95% CI = 1.42, 2.50) had worse overall survival than did non-Hispanic White women living in high-SES neighborhoods. Results were similar for breast cancer-specific survival, except that African Americans and non-Hispanic Whites living in high-SES neighborhoods had similar survival.
ConclusionsStrategies to address the underlying factors that may influence treatment intensity and adherence, such as comorbidities and logistical barriers, should be targeted at low-SES non-Hispanic White and all African American patients.
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