Exploring differences in breast cancer prognostic factors between Caucasian-American and African-American women in the United States.

摘要

Breast cancer survival among African-American women is lower than that of Caucasian-American women in the United States; yet, little research has been done to establish potential causative agents. The purpose of this study is to explore how differences in breast cancer prognostic factors contribute to the diminished survival rate among African-American women in order to improve breast cancer education and screening initiatives. Data was obtained from the Surveillance Epidemiology and End Results (SEER) database for all breast cancers in African-American and Caucasian-American women reported between 2000 and 2003. A total of 147,057 eligible cases were identified and data were analyzed using chi-square and post hoc analysis of standard residuals to test 3 hypotheses: (a) There is a difference in terms of the age at which breast cancer is diagnosed; (b) There is a difference in terms of the histological type of breast cancer diagnosed; and, (c) There is a difference in terms of the stage at which breast cancer is diagnosed between Caucasian-American and African-American women. Relative to Caucasian-American women, African-American women were found to be diagnosed with breast cancer at younger ages (p 0.001), with more aggressive tumor histology (p 0.001), and at more advanced stages ( p 0.001). Using Cox regression analysis, age at diagnosis was found to be the most predictive factor for survival, where African-American women are 2 times more likely than Caucasian-American women to be diagnosed with breast cancer before the age of 40. Differences in breast cancer age at diagnosis, histology, and stage are present by race. However, a unified effort from community leaders, public health educators, and clinical professionals to improve breast cancer education and screening endeavors for African-American women may improve mortality rates and create the social change necessary to eliminate breast cancer disparities.