TY - JOUR
T1 - Racial/ethnic disparities in survival after breast cancer diagnosis by estrogen and progesterone receptor status
T2 - A pooled analysis
AU - John, Esther M.
AU - McGuire, Valerie
AU - Kurian, Allison W.
AU - Koo, Jocelyn
AU - Shariff-Marco, Salma
AU - Gomez, Scarlett Lin
AU - Cheng, Iona
AU - Keegan, Theresa H.M.
AU - Kwan, Marilyn L.
AU - Bernstein, Leslie
AU - Vigen, Cheryl
AU - Wu, Anna H.
N1 - Funding Information:
V. McGuire reports grants from Stanford University during the conduct of the study. A.W. Kurian reports grants from Myriad Genetics outside the submitted work. S. Shariff-Marco reports grants from California Breast Cancer Research Program during the conduct of the study. S.L. Gomez reports grants from California Breast Cancer Research Program during the conduct of the study. L. Bernstein reports grants from State of California Breast Cancer Research Program and National Institutes of Health during the conduct of the study. C. Vigen reports grants from California Breast Cancer Research Program during the conduct of the study, as well as grants from California Breast Cancer Research Program outside the submitted work. No disclosures were reported by the other authors.
Funding Information:
This work was supported by the California Breast Cancer Research Program (CBCRP; grant 16ZB-8001, to A.H. Wu, R. Sposto, C. Vigen; 16ZB-8002, to S.L. Gomez, T.H.M. Keegan, S. Shariff-Marco, J. Koo, J. Yang, A.W. Kurian, E.M. John; 16ZB-8003, to L. Bernstein, Y. Lu; 16ZB-8004, to M.L. Kwan; and 16ZB-8005, to K.R. Monroe, I. Cheng, B.E. Henderson). The John Cancer Research Program Fund supported the work by V. McGuire. The Asian American Breast Cancer Study was supported by CBCRP grants (1RB-0287, 3PB-0120, and 5PB-0018; to A.H. Wu). The San Francisco Bay Area Breast Cancer Study was supported by NCI grants R01 CA063446 and R01 CA077305; by the U.S. Department of Defense (DOD) grant DAMD17-96-1-6071; and by the CBCRP grants (1RB-0125, to P.L. Horn-Ross;
Funding Information:
7PB-0068, to E.M. John). The Women’s Contraceptive and Reproductive Experiences (CARE) Study was funded by the National Institute of Child Health and Human Development (NICHD), through a contract with USC (N01-HD-3-3175). The California Teachers Study was funded by the California Breast Cancer Act of 1993, NCI grants (R01 CA77398 and K05 CA136967, to L. Bernstein), and the California Breast Cancer Research Fund (contract 97-10500, to L. Bernstein). The Multiethnic Cohort Study is supported by NCI grants (R01 CA54281, R37CA54281, and U01 CA164973, to L. Le Marchand, L.R. Wilkens, and C. Haiman). The Life After Cancer Epidemiology Study is supported by NCI grant R01 CA129059, to B.J. Caan). The Breast Cancer Family Registry is supported by the NCI grant (U01 CA164920, to I. Andrulis, S. Colonna, M. Daly, J.L. Hopper, E.M. John, and M.B. Terry). The collection of cancer incidence data used in this study was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention’s (CDC) National Program of
Funding Information:
This work was supported by the California Breast Cancer Research Program (CBCRP; grant 16ZB-8001, to A.H. Wu, R. Sposto, C. Vigen; 16ZB-8002, to S.L. Gomez, T.H.M. Keegan, S. Shariff-Marco, J. Koo, J. Yang, A.W. Kurian, E.M. John; 16ZB-8003, to L. Bernstein, Y. Lu; 16ZB-8004, to M.L. Kwan; and 16ZB-8005, to K.R. Monroe, I. Cheng, B.E. Henderson). The John Cancer Research Program Fund supported the work by V. McGuire. The Asian American Breast Cancer Study was supported by CBCRP grants (1RB-0287, 3PB-0120, and 5PB-0018; to A.H. Wu). The San Francisco Bay Area Breast Cancer Study was supported by NCI grants R01 CA063446 and R01 CA077305; by the U.S. Department of Defense (DOD) grant DAMD17-96-1-6071; and by the CBCRP grants (1RB-0125, to P.L. Horn-Ross; 7PB-0068, to E.M. John). The Women's Contraceptive and Reproductive Experiences (CARE) Study was funded by the National Institute of Child Health and Human Development (NICHD), through a contract with USC (N01-HD-3-3175). The California Teachers Study was funded by the California Breast Cancer Act of 1993, NCI grants (R01 CA77398 and K05 CA136967, to L. Bernstein), and the California Breast Cancer Research Fund (contract 97-10500, to L. Bernstein). The Multiethnic Cohort Study is supported by NCI grants (R01 CA54281, R37CA54281, and U01 CA164973, to L. Le Marchand, L.R. Wilkens, and C. Haiman). The Life After Cancer Epidemiology Study is supported by NCI grant R01 CA129059, to B.J. Caan). The Breast Cancer Family Registry is supported by the NCI grant (U01 CA164920, to I. Andrulis, S. Colonna, M. Daly, J.L. Hopper, E.M. John, and M.B. Terry). The collection of cancer incidence data used in this study was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention's (CDC) National Program of Cancer Registries, under cooperative agreement 5NU58DP006344; and the NCI's Surveillance, Epidemiology and End Results Program under contract HHSN261201800032I awarded to the University of California, San Francisco, contract HHSN261201800015I awarded to the University of Southern California, and contract HHSN261201800009I awarded to the Public Health Institute, Cancer Registry of Greater California.
Publisher Copyright:
© 2020 American Association for Cancer Research.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - Background: Limited studies have investigated racial/ethnic survival disparities for breast cancer defined by estrogen receptor (ER) and progesterone receptor (PR) status in a multiethnic population. Methods: Using multivariable Cox proportional hazards models, we assessed associations of race/ethnicity with ER/PR-specific breast cancer mortality in 10,366 California women diagnosed with breast cancer from 1993 to 2009. We evaluated joint associations of race/ethnicity, health care, sociodemographic, and lifestyle factors with mortality. Results: Among women with ER/PRþ breast cancer, breast cancer-specific mortality was similar among Hispanic and Asian American women, but higher among African American women [HR, 1.31; 95% confidence interval (CI), 1.05-1.63] compared with non-Hispanic White (NHW) women. Breast cancer-specific mortality was modified by surgery type, hospital type, education, neighborhood socioeconomic status (SES), smoking history, and alcohol consumption. Among African American women, breast cancer-specific mortality was higher among those treated at nonaccredited hospitals (HR, 1.57; 95% CI, 1.21-2.04) and those from lower SES neighborhoods (HR, 1.48; 95% CI, 1.16-1.88) compared with NHW women without these characteristics. Breast cancer-specific mortality was higher among African American women with at least some college education (HR, 1.42; 95% CI, 1.11-1.82) compared with NHW women with similar education. For ER-/PR- disease, breast cancer-specific mortality did not differ by race/ ethnicity and associations of race/ethnicity with breast cancer-specific mortality varied only by neighborhood SES among African American women. Conclusions: Racial/ethnic survival disparities are more striking for ER/PR+ than ER-/PR- breast cancer. Social determinants and lifestyle factors may explain some of the survival disparities for ER/PR+ breast cancer. Impact: Addressing these factors may help reduce the higher mortality of African American women with ER/PR+ breast cancer.
AB - Background: Limited studies have investigated racial/ethnic survival disparities for breast cancer defined by estrogen receptor (ER) and progesterone receptor (PR) status in a multiethnic population. Methods: Using multivariable Cox proportional hazards models, we assessed associations of race/ethnicity with ER/PR-specific breast cancer mortality in 10,366 California women diagnosed with breast cancer from 1993 to 2009. We evaluated joint associations of race/ethnicity, health care, sociodemographic, and lifestyle factors with mortality. Results: Among women with ER/PRþ breast cancer, breast cancer-specific mortality was similar among Hispanic and Asian American women, but higher among African American women [HR, 1.31; 95% confidence interval (CI), 1.05-1.63] compared with non-Hispanic White (NHW) women. Breast cancer-specific mortality was modified by surgery type, hospital type, education, neighborhood socioeconomic status (SES), smoking history, and alcohol consumption. Among African American women, breast cancer-specific mortality was higher among those treated at nonaccredited hospitals (HR, 1.57; 95% CI, 1.21-2.04) and those from lower SES neighborhoods (HR, 1.48; 95% CI, 1.16-1.88) compared with NHW women without these characteristics. Breast cancer-specific mortality was higher among African American women with at least some college education (HR, 1.42; 95% CI, 1.11-1.82) compared with NHW women with similar education. For ER-/PR- disease, breast cancer-specific mortality did not differ by race/ ethnicity and associations of race/ethnicity with breast cancer-specific mortality varied only by neighborhood SES among African American women. Conclusions: Racial/ethnic survival disparities are more striking for ER/PR+ than ER-/PR- breast cancer. Social determinants and lifestyle factors may explain some of the survival disparities for ER/PR+ breast cancer. Impact: Addressing these factors may help reduce the higher mortality of African American women with ER/PR+ breast cancer.
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U2 - 10.1158/1055-9965.EPI-20-1291
DO - 10.1158/1055-9965.EPI-20-1291
M3 - Article
C2 - 33355191
AN - SCOPUS:85101355602
VL - 30
SP - 351
EP - 363
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
SN - 1055-9965
IS - 2
ER -