Abstract
Objectives: We 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. Methods: Using 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. Results: After 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. Conclusions: Strategies 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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 938-946 |
| Number of pages | 9 |
| Journal | American Journal of Public Health |
| Volume | 105 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 1 2015 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
Cite this
Racial/ethnic and socioeconomic differences in short-term breast cancer survival among women in an integrated health system. / Keegan, Theresa H; Kurian, Allison W.; Gali, Kathleen; Tao, Li; Lichtensztajn, Daphne Y.; Hershman, Dawn L.; Habel, Laurel A.; Caan, Bette J.; Gomez, Scarlett L.
In: American Journal of Public Health, Vol. 105, No. 5, 01.05.2015, p. 938-946.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Racial/ethnic and socioeconomic differences in short-term breast cancer survival among women in an integrated health system
AU - Keegan, Theresa H
AU - Kurian, Allison W.
AU - Gali, Kathleen
AU - Tao, Li
AU - Lichtensztajn, Daphne Y.
AU - Hershman, Dawn L.
AU - Habel, Laurel A.
AU - Caan, Bette J.
AU - Gomez, Scarlett L.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Objectives: We 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. Methods: Using 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. Results: After 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. Conclusions: Strategies 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.
AB - Objectives: We 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. Methods: Using 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. Results: After 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. Conclusions: Strategies 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.
UR - http://www.scopus.com/inward/record.url?scp=84926653381&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84926653381&partnerID=8YFLogxK
U2 - 10.2105/AJPH.2014.302406
DO - 10.2105/AJPH.2014.302406
M3 - Article
C2 - 25790426
AN - SCOPUS:84926653381
VL - 105
SP - 938
EP - 946
JO - American Journal of Public Health
JF - American Journal of Public Health
SN - 0090-0036
IS - 5
ER -