Evaluating the disparity of female breast cancer mortality among racial groups - a spatiotemporal analysis

Abstract

BackgroundThe literature suggests that the distribution of female breast cancer mortality demonstrates spatial concentration. There remains a lack of studies on how the mortality burden may impact racial groups across space and over time. The present study evaluated the geographic variations in breast cancer mortality in Texas females according to three predominant racial groups (non-Hispanic White, Black, and Hispanic females) over a twelve-year period. It sought to clarify whether the spatiotemporal trend might place an uneven burden on particular racial groups, and whether the excess trend has persisted into the current decade.MethodsThe Spatial Scan Statistic was employed to examine the geographic excess of breast cancer mortality by race in Texas counties between 1990 and 2001. The statistic was conducted with a scan window of a maximum of 90% of the study period and a spatial cluster size of 50% of the population at risk. The next scan was conducted with a purely spatial option to verify whether the excess mortality persisted further. Spatial queries were performed to locate the regions of excess mortality affecting multiple racial groups.ResultsThe first scan identified 4 regions with breast cancer mortality excess in both non-Hispanic White and Hispanic female populations. The most likely excess mortality with a relative risk of 1.12 (p = 0.001) occurred between 1990 and 1996 for non-Hispanic Whites, including 42 Texas counties along Gulf Coast and Central Texas. For Hispanics, West Texas with a relative risk of 1.18 was the most probable region of excess mortality (p = 0.001). Results of the second scan were identical to the first. This suggested that the excess mortality might not persist to the present decade. Spatial queries found that 3 counties in Southeast and 9 counties in Central Texas had excess mortality involving multiple racial groups.ConclusionSpatiotemporal variations in breast cancer mortality affected racial groups at varying levels. There was neither evidence of hot-spot clusters nor persistent spatiotemporal trends of excess mortality into the present decade. Non-Hispanic Whites in the Gulf Coast and Hispanics in West Texas carried the highest burden of mortality, as evidenced by spatial concentration and temporal persistence.

Efficient mapping and geographic disparities in breast cancer mortality at the county-level by race and age in the U.S.

“…Our results based on kriging and the STAR model were generally similar to previous studies that have focused on local breast cancer mortality, such as Houston, Dallas and San Antonio for African American women (Tian et al, 2011) and in Gulf Coast Texas for both non-Hispanic Whites and Blacks (Hsu et al, 2004). Regardless of race, areas in the Northeast U.S., such as New York, Philadelphia, and the east coast from Baltimore to Boston, had elevated breast cancer mortality rates (Goovaerts, 2005; Kulldorff et al, 1997).…”

A Bayesian Method for Cluster Detection with Application to Brain and Breast Cancer in Puget Sound

“…For example, scan statistics have been used to detect clusters for breast cancer in Massachusetts, 27 Texas, 28 Connecticut, 29 and across all counties in the United States 30 . An interpretation of geographical variation across the United States has also been carried out, 31 with a major conclusion being that at large scales at least, there are differences in presentation (i.e.…”

Disparities in Female Breast Cancer Stage at Diagnosis in New Jersey: A Spatial-Temporal Analysis

“…Breast cancer and other cancers have been studied over space and time, including breast cancer incidence, 8 – 10 breast cancer mortality, 11 proportion of in situ or late-stage breast cancer, 12 , 13 proportion of late-stage prostate cancer, 14 , 15 and brain cancer incidence. 16 The space-time scan statistic in SaTScan software was used in some of these cancer studies, 11 , 13 , 16 as well as in studies of other health problems such as accidental poisoning 17 and AIDS mortality. 18 , 19 …”