The 130th Annual Meeting of APHA

Abstract #35124

Nina S. Wampler, DSc, MPH, Department of Psychiatry, Division of American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, University North Pavilion, 4455 East Twelfth Avenue, A011-13, Denver, CO 80220, 303-315-9232, nsw@w-d.org, Timothy L Lash, DSc MPH, Department of Epidemiology, Boston University School of Public Health, 715 Albany St., Boston, MA 02472, and Rebecca A. Silliman, MD, PhD, Boston University Schools of Medicine and Public Health, 88 East Newton Street, F4, Boston, MA 02118.

The objective of this study was to compare the survival experiences after diagnosis of breast cancer in American Indian and Alaska Native and non-Hispanic white women. Across 11 geographic locations in the US, this study identified 511 American Indian and Alaska Native (AI/AN) women 40 years and older, diagnosed with first occurrence of invasive breast cancer, 1973-1996, obtained from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program. Each AI/AN woman was matched to 4 non-Hispanic white women from the same SEER geographic location with the same month and year of diagnosis as the AI/AN woman. The unadjusted five-year survival probability for AI/AN women was 0.70 (0.64-0.76), compared to 0.82 (0.80-0.84) for non-Hispanic White women. In multivariable Cox proportional hazards regression analyses, controlling for age at diagnosis, marital status, stage at diagnosis, tumor size, node involvement, surgery and radiation, American Indian/Alaska Native women had poorer survival after diagnosis when compared with non-Hispanic white women: hazard ratio, 95% CI: 1.55, (1.26-1.90). Further adjustment for positive estrogen and progesterone receptor tests showed similar results: odds ratio, 95% CI: 2.26, (1.32-3.87). Further studies should include information on mammography, as well as the timing and details of breast cancer treatment to facilitate better understanding of the poorer survival of American Indian and Alaska Native women.

Learning Objectives: At the conclusion of this presentation, the participant in this session will be able to

• Recognize the difference in crude five-year survival probabilities of American Indian/Alaska Native women and non-Hispanic White women diagnosed with non-recurrent invasive breast cancer.
• Describe differences between American Indian/Alaska Native women and non-Hispanic White women in terms of demographic and clinical factors related to breast cancer diagnosis and treatment.
• Assess the survival experiences of American Indian/Alaska Native women compared to non-Hispanic White women, stratified by stage of cancer at diagnosis and adjusted for demographic and clinical factors.

Keywords: Breast Cancer, Native Americans

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Susan G. Komen Foundation (dissertation grant funded my research) Surveillance, Epidemiology and End Results Program of the National Cancer Institute
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.