141st APHA Annual Meeting

In This section

283731
Female breast cancer disparities in stage at diagnosis by race, ethnicity, and socioeconomic status

Tuesday, November 5, 2013

Stacey L. Tannenbaum, PhD, RD, LD/N , Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
Tulay Koru-Sengul, MHS, PhD , Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL
Feng Miao, MSc , University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, Miami, FL
Margaret M. Byrne, PhD , Dept. of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL
Introduction: Female breast cancer diagnosis at an early stage is paramount for positive survival outcomes. However, disparities of stage at diagnosis by race, ethnicity, and socioeconomic status (SES) exist. We examined these disparities in a population-based sample.

Methods: Data were obtained from the 1996-2009 Florida Cancer Data System linked with the Agency for Health Care Administration database (n=135,899). Stage (localized, regional with/without direct extension, distant), race (White, Black, Native American, Asian, or other), ethnicity (Hispanic or non-Hispanic) and SES (%living in poverty: lowest (≥20%), middle-low (≥10% and <20%), middle-high (≥5% and <10%), highest (<5%) were studied. Results: Overall, 66% of women were diagnosed at localized and 5% at distant stage. Reporting extreme values: 67% of Whites (highest) and 53% of Blacks (lowest) were diagnosed at localized stage; 12% of Native Americans and 4% of Asians were diagnosed at distant stage. A higher percent of non-Hispanics (66%) vs. Hispanics (61%) were diagnosed at localized stage; however an equal percent (5%) were diagnosed at distant stage. There was an increasing proportion of localized diagnosis between lowest (59%) to highest SES (67%) and a decreasing proportion of distant (7%-4%). Overall, median survival time (MST) was 11.9 years. Whites had a longer MST than Blacks (12 vs. 9.5 years, respectively); Hispanics had a longer MST than non-Hispanics (12.9 vs. 11.8 years, respectively) despite less localized disease.

Conclusion: Disparities by stage at diagnosis are evident in the state of Florida. Research is needed to determine if screening practice disparities are the cause.

Learning Areas:
Chronic disease management and prevention
Diversity and culture
Epidemiology
Public health or related research

Learning Objectives:
Compare the racial, ethnic, and socioeconomic status differences of breast cancer stage by diagnosis. Discuss the median survival time for White and Black races relative to the overall median survival time. Explain the discrepancy in median survival time and proportion of localized disease for Hispanic and non-Hispanic patients.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract author because I have been a co-investigator and consultant under multiple federally funded grants focusing on the epidemiology of cancer of the breast and lung and disparities by race, ethnicity, and socioeconomic status.
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.