Breast cancer among black women: Disparity in stage, survival rate and mortality

Objectives: Female breast cancer is the leading cancer among women in the U.S. Blacks have a higher mortality than whites, regardless of having a lower incidence. This study is to assess racial disparity in stage of cancer and survival of patient, which may contribute to the disparity in breast cancer mortality.

Methods: Breast cancer incidence, stage, survival rate and mortality were analyzed using Florida Cancer Data System data in 1981-2005. Factors associated with advanced stage of cancer and survival of patient were assessed. These factors include race, age, poverty level, health insurance, tumor characteristics, type of treatments and comorbidity.

Results: in 2005, 12,428 women were diagnosed with breast cancer, and 2,663 died from breast cancer. The incidence was higher among whites than blacks during 1981 through 2005. The mortality among blacks exceeded that among whites in 1984, and the disparity has been widening since then. The percent of cancer diagnosed in advanced stages was higher among blacks than whites in all years. Tumor characteristics, patient's characteristics and type of treatment were associated with survival rate. Blacks had a poor survival rate (adjusted hazard ratio=1.3) than whites after controlling for all risk factors.

Conclusions: Blacks were more likely to be diagnosed at advanced stages, and to have a poor survival rate than whites. Both disparity in stage and survival may contribute to a high mortality among blacks. Improving cancer screening may reduce the number of blacks diagnosed at advanced stages. Further studies are needed for optimal treatments for black patients