Contribution of clinical and socioeconomic factors to differences in breast cancer subtype and mortality between Hispanic and non-Hispanic white women

María Elena Martínez, Scarlett L. Gomez, Li Tao, Rosemary D Cress, Danielle Rodriguez, Jonathan Unkart, Richard Schwab, Jesse N. Nodora, Linda Cook, Ian Komenaka, Christopher Li

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: To assess tumor subtype distribution and the relative contribution of clinical and sociodemographic factors on breast cancer survival between Hispanic and non-Hispanic whites (NHWs). Methods: We analyzed data from the California Cancer Registry, which included 29,626 Hispanic and 99,862 NHW female invasive breast cancer cases diagnosed from 2004 to 2014. Logistic regression was used to assess ethnic differences in tumor subtype, and Cox proportional hazard modeling to assess differences in breast cancer survival. Results: Hispanics compared to NHWs had higher odds of having triple-negative (OR = 1.29; 95% CI 1.23–1.35) and HER2-overexpressing tumors (OR = 1.19; 95% CI 1.14–1.25 [HR−] and OR = 1.39; 95% CI 1.31–1.48 [HR+]). In adjusted models, Hispanic women had a higher risk of breast cancer mortality than NHW women (mortality rate ratio [MRR] = 1.24; 95% CI 1.19–1.28). Clinical factors accounted for most of the mortality difference (MRR = 1.05; 95% CI 1.01–1.09); however, neighborhood socioeconomic status (SES) and health insurance together accounted for all of the mortality difference (MRR = 1.01; 95% CI 0.97–1.05). Conclusions: Addressing SES disparities, including increasing access to health care, may be critical to overcoming poorer breast cancer outcomes in Hispanics.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalBreast Cancer Research and Treatment
DOIs
StateAccepted/In press - Jul 11 2017
Externally publishedYes

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Hispanic Americans
Breast Neoplasms
Mortality
Social Class
Neoplasms
Health Services Accessibility
Survival
Health Insurance
Registries
Logistic Models

Keywords

  • Breast cancer
  • Disparities
  • Health insurance
  • Hispanic
  • Socioeconomic factors

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Contribution of clinical and socioeconomic factors to differences in breast cancer subtype and mortality between Hispanic and non-Hispanic white women. / Martínez, María Elena; Gomez, Scarlett L.; Tao, Li; Cress, Rosemary D; Rodriguez, Danielle; Unkart, Jonathan; Schwab, Richard; Nodora, Jesse N.; Cook, Linda; Komenaka, Ian; Li, Christopher.

In: Breast Cancer Research and Treatment, 11.07.2017, p. 1-9.

Research output: Contribution to journalArticle

Martínez, María Elena ; Gomez, Scarlett L. ; Tao, Li ; Cress, Rosemary D ; Rodriguez, Danielle ; Unkart, Jonathan ; Schwab, Richard ; Nodora, Jesse N. ; Cook, Linda ; Komenaka, Ian ; Li, Christopher. / Contribution of clinical and socioeconomic factors to differences in breast cancer subtype and mortality between Hispanic and non-Hispanic white women. In: Breast Cancer Research and Treatment. 2017 ; pp. 1-9.
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AU - Cress, Rosemary D

AU - Rodriguez, Danielle

AU - Unkart, Jonathan

AU - Schwab, Richard

AU - Nodora, Jesse N.

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N2 - Purpose: To assess tumor subtype distribution and the relative contribution of clinical and sociodemographic factors on breast cancer survival between Hispanic and non-Hispanic whites (NHWs). Methods: We analyzed data from the California Cancer Registry, which included 29,626 Hispanic and 99,862 NHW female invasive breast cancer cases diagnosed from 2004 to 2014. Logistic regression was used to assess ethnic differences in tumor subtype, and Cox proportional hazard modeling to assess differences in breast cancer survival. Results: Hispanics compared to NHWs had higher odds of having triple-negative (OR = 1.29; 95% CI 1.23–1.35) and HER2-overexpressing tumors (OR = 1.19; 95% CI 1.14–1.25 [HR−] and OR = 1.39; 95% CI 1.31–1.48 [HR+]). In adjusted models, Hispanic women had a higher risk of breast cancer mortality than NHW women (mortality rate ratio [MRR] = 1.24; 95% CI 1.19–1.28). Clinical factors accounted for most of the mortality difference (MRR = 1.05; 95% CI 1.01–1.09); however, neighborhood socioeconomic status (SES) and health insurance together accounted for all of the mortality difference (MRR = 1.01; 95% CI 0.97–1.05). Conclusions: Addressing SES disparities, including increasing access to health care, may be critical to overcoming poorer breast cancer outcomes in Hispanics.

AB - Purpose: To assess tumor subtype distribution and the relative contribution of clinical and sociodemographic factors on breast cancer survival between Hispanic and non-Hispanic whites (NHWs). Methods: We analyzed data from the California Cancer Registry, which included 29,626 Hispanic and 99,862 NHW female invasive breast cancer cases diagnosed from 2004 to 2014. Logistic regression was used to assess ethnic differences in tumor subtype, and Cox proportional hazard modeling to assess differences in breast cancer survival. Results: Hispanics compared to NHWs had higher odds of having triple-negative (OR = 1.29; 95% CI 1.23–1.35) and HER2-overexpressing tumors (OR = 1.19; 95% CI 1.14–1.25 [HR−] and OR = 1.39; 95% CI 1.31–1.48 [HR+]). In adjusted models, Hispanic women had a higher risk of breast cancer mortality than NHW women (mortality rate ratio [MRR] = 1.24; 95% CI 1.19–1.28). Clinical factors accounted for most of the mortality difference (MRR = 1.05; 95% CI 1.01–1.09); however, neighborhood socioeconomic status (SES) and health insurance together accounted for all of the mortality difference (MRR = 1.01; 95% CI 0.97–1.05). Conclusions: Addressing SES disparities, including increasing access to health care, may be critical to overcoming poorer breast cancer outcomes in Hispanics.

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