Examination of racial disparities in comorbidities and stage at diagnosis among breast cancer patients in South Carolina

Background In South Carolina, breast cancer is the most commonly diagnosed cancer among women, regardless of race, accounting for 32% of all female cancer cases. South Carolina experiences significant disparities in breast cancer mortality between African and White American women.

Methods This is a cohort study that examines the relationships between comorbidity and stage at diagnosis among Medicaid recipients with breast cancer in South Carolina from 2006-2008. Medicaid was chosen to control for insurance status and included demographic variables such as race, age, and county of residence. ICD-9 codes were used to classify the most common comorbidity categories. Medicaid data were linked to the South Carolina Cancer Registry, which provides stage at diagnosis. Logistic regression was used to determine whether the presence comorbidities is a predictor of stage at diagnosis and chi-square analysis was used to compare differences in comorbidity count on stage at diagnosis.

Results Preliminary analysis suggests that significant racial differences exist in stage at diagnosis; African Americans presenting at later stages. These differences can be partially explained by the differences in the presence and severity of comorbidities.

Discussion This study will discuss the relationship between comorbidity and stage at diagnosis of breast cancer. A better understanding of how comorbid illnesses may compete for medical attention preventing early detection of breast cancer. This will lead to the development of policies to address the issues of health care delivery and quality.