197372 Late-stage diagnosis of breast cancer among Asian and Pacific Islander subgroups

Monday, November 9, 2009

Erin Touslee, MPH CHES , Orange County Affiliate of Susan G Komen for the Cure, Costa Mesa, CA
Sarah F. Marshall, MA , Department of Epidemiology, University of California, Irvine, Irvine, CA
Argyrios Ziogas, PhD , Department of Epidemiology, University of California, Irvine, Irvine, CA
Jorge Castaneda, MPH , Orange County Affiliate of Susan G Komen for the Cure, Costa Mesa, CA
Hoda Anton-Culver, PhD , Department of Epidemiology, Irvine, CA
Background/significance: A late stage diagnosis of breast cancer can indicate inadequate screening. It has been reported previously that Asian and Pacific Islander (API) women have fewer late-stage diagnoses than women of other race/ethnicities, but studies rarely examine API subgroups. Objective/Purpose: We previously found that the odds of late-stage diagnosis of breast cancer differed by API ethnicity in Orange County, California. In this study we explore stage of diagnosis for API subgroups in California. Methods: Primary breast cancers were identified using the statewide California Cancer Registry for 1991-2005. We categorized breast cancer cases as early (confined to the breast) or late stage. Race/ethnicity was abstracted from the patients' medical records. Logistic regression was used to calculate the odds of late stage diagnosis, adjusting for age and year of diagnosis. Results: Of 25,177 API women with breast cancer in California, 7,799 (31%) were diagnosed at a late stage. In regression analysis, API had significantly reduced odds of being diagnosed late stage, compared to non-Hispanic white women. Among API ethnicities, Chinese (OR=0.88, 95% CI = 0.84, 0.94) and Japanese (OR=0.83, 95% CI = 0.77, 0.89) breast cancer patients also had significantly reduced odds of late stage diagnosis compared to non-Hispanic whites, but Pacific Islanders (OR=1.37, 95% CI = 1.17, 1.61) and South Asians (OR=1.28, 95% CI = 1.14, 1.44) had significantly increased risks. Discussion/Conclusions: The likelihood of being diagnosed with breast cancer at a late-stage differed by API subgroup; Pacific Islander and South Asian women were at higher risk.

Learning Objectives:
By the end of the session, the participant will be able to identify Asian Pacific Islander (API) subpopulations at risk for late stage diagnosis of breast cancer. By the end of the session, the participant will be able to explain that combining API ethnicities into a single group for analysis may hide disparities and targets for health prevention within the group.

Keywords: Breast Cancer Screening, Cancer Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Masters Degree of Public Health Certified Health Education Specialist Advisory Member that provided direct oversight on the data analyses of the project in which the data is drawn from
Any relevant financial relationships? No

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.