A Five-Year Breast Cancer-Specific Survival Disadvantage of African American Women

Abstract

Racial/ethnic disparities in female breast cancer survival continue to persist in United States. However, disparities comparing African Americans (AA), Asians and Caucasians remain to be assessed. We aimed to assess multiracial/ethnic disparities in breast cancer survival, and to examine the factors that may explain the variability. A total of 6,951 women diagnosed with breast cancer between 1992 and 1998 were identified from Surveillance, Epidemiology, and End Results tumor registries. The effect of race/ethnicity and the prognostic factors on survival was assessed using Cox proportional hazard model. AA demonstrated a survival disadvantage. Compared to Asians, Caucasians had 74% increased risk of dying (HR= 1.74, 95% CI = 1.31 – 2.33), while AA were almost three times as likely as Asians to die, (HR=2.78, 95% CI 2.02 – 3.86). After adjustment for the relevant covariates the survival disadvantage of AA persisted. Relative to Asians, Caucasians were 45% more likely to die (HR=1.45, 95% CI 1.10 – 1.93), while AA were more than two times as likely to die (HR=2.57, 95% CI 1.86 - 3.55). There were substantial racial/ethnic disparities in breast cancer survival among United States women. AA demonstrated survival disadvantage compared with either Caucasians or Asians, which persisted even after controlling factors known to influence breast cancer survival (Afr. J. Reprod. Health 2010; 14[3]: 195-200).

Key words: African American Women; breast cancer survival; racial/ethnic disparities; United States.