159513 Breast cancer survival analysis among economically disadvantaged women: The influences of delayed diagnosis and treatment on mortality

Monday, November 5, 2007: 1:30 PM

Emily Smith, MSPH, CCRC , Program on Aging and Care, Scott and White's Memorial Hospital, Temple, TX
Swann Arp Adams, PhD , Department of Epidemiology and Biostatistics & College of Nursing, University of South Carolina, Columbia, SC
Irene P. Prabhu Das, PhD , Division of Cancer Control & Population Sciences, National Cancer Institute, Bethesda, MD
James R. Hebert, ScD , Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
Significance: Breast cancer (BrCA) impacts thousands each year in the United States, and unfortunately disproportionately affects certain subgroups, such as underserved women and African-American (AA) women. The purpose of the study was to elucidate factors associated with BrCA mortality among these groups. To our knowledge, no study has analyzed mortality and prolonged intervals among this cohort of women.

Methods: Participants (n=314) of the Best Chance Network (BCN), a program which provides BrCA screening to age- and income-eligible women, were included in the study. Data, including tumor characteristics, time delay intervals (ie. intervals between screening and diagnosis or treatment), and racial inequities, were examined using chi-square or t-test statistics and Kruskal-Wallis tests. Cox regression modeling was used to assess the relationship between delay intervals and other factors among AA and EA women.

Results: Among participants in our study, AA women had lower income levels than EA women. No racial differences were found in age at diagnosis, tumor behavior, stage, grade, size, and hormonal-receptor status. Diagnosis and treatment intervals were not statistically different between AA and EA (p-value=.36, p-value=.34, respectively). Racial mortality differences were not explained by time delay intervals but were affected by prognostic factors.

Discussion: These findings suggest that targeted BrCA screening efforts through programs, such as the BCN, ensure prompt follow-up of breast abnormalities and treatment initiation among economically disadvantaged women and racial groups. Additionally, these findings highlight the need for future research into the etiology of racial differences, and their impact on survival of patients with breast cancer.

Learning Objectives:
(1) Describe factors associated with breast cancer incidence and mortality among African-American and European-American women in South Carolina; and (2) Discuss the importance of cancer screening programs for medically underserved women as connections to care.

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.