Breast cancer size and stage in Hispanic American women, by birthplace: 1992-1995

Abstract

A B S T R A C TObjectives. This study examined whether Hispanic women with breast cancer have tumor characteristics associated with delayed detection and whether these characteristics vary by birthplace.Methods. Surveillance, Epidemiology, and End Results program data were used in examining breast cancer size and stage by racial/ethnic group and birthplace.Results. Hispanic Americans are one of the fastest growing racial/ethnic groups in the country, constituting 9% of the total US population. [1][2][3] By the end of the decade, the Hispanic population is expected to be the largest ethnic group in the United States.1 Among Hispanic women, breast cancer is the most common malignancy and the leading cause of cancer deaths. 4,5 It is well known that regular breast cancer screening increases early detection and significantly reduces breast cancer mortality.6-9 Therefore, it is of concern that Hispanic women are less likely to report using breast cancer screening than women in the general US population. 10,11 In the present study, we examined whether Hispanic women had breast cancer characteristics that reflect delayed tumor detection (i.e., large tumor size and advanced stage of disease). We further assessed whether these tumor characteristics varied by place of birth. Methods Study Subjects and Data CollectionStudy subjects were Hispanic women in 4 Surveillance, Epidemiology, and End Results (SEER) program regions who had been diagnosed with in situ or invasive breast cancer at 40 years or older between 1992 and 1995. Non-Hispanic White women meeting the same criteria were the comparison group. The San Francisco/Oakland, San Jose/Monterey, Los Angeles, and New Mexico regions were included because these SEER registries have the largest Hispanic populations. 4 The regional SEER registries obtain case information primarily through record abstraction from hospitals and pathology laboratories.12 Additional data are obtained from death certificates. Information on race/ethnicity, obtained from hospital and death records, is comparable to US Bureau of the Census race/ ethnicity identifiers. When no ethnicity information is available, Hispanics are identified via the 1980 census Spanish surname list.Hispanic women were grouped in 2 birthplace categories (United States and LatinAmerica). In this study, Hispanic Americans born in LatinAmerica were considered first-generation Americans, and those born in the United States were considered later-generation Americans. Hispanic women with missing birthplace data and those born outside the United States or Latin America were not included in the analyses in which birthplace was an exposure variable. Statistical AnalysisWe examined 3 outcomes that reflect timeliness of breast cancer diagnosis (i.e., early diagnosis vs late diagnosis): tumor size categorized as 1 cm or smaller vs 1 cm or larger, tumor size categorized as 2 cm or smaller vs 2 cm or larger, and tumor stage at diagnosis classified as in situ/localized (early stage) vs regional/distant (advanced stage). Information on tu...

“¿Qué viene después?”: Latina women diagnosed with breast cancer twice.

“…Both guidelines apply to all women in the U.S. regardless of factors that may indicate differential screening schedules. Consistent with past research (e.g., Clarke et al, 2012;Hedeen & White, 2001), in a recent comparative study researchers found that 3 in 10 Latina women were under 50 years old when diagnosed with breast cancer (Nahleh et al, 2018). Even more concerning is the fact that 8% of the women were diagnosed before the age of 40.…”

The influence of nativity and neighborhoods on breast cancer stage at diagnosis and survival among California Hispanic women

“…Our imputation of nativity, although an improvement over prior methods [ 49 ], is subject to some error; however, given similar sensitivity and positive predictive value rates in the method, it is likely that misclassification as foreign-born balanced misclassification as US-born. The impact on case counts within groups defined by nativity is likely small, given that nativity was imputed for about one-quarter of cancer patients, and that prior research has found high accuracy for cancer registry birthplace data [ 23 , 24 , 50 ].…”

Trends in Cancer Screening by Citizenship and Health Insurance, 2000–2010

“…It is estimated that after all mandates are implemented, about a quarter of the uninsured population will be undocumented foreign-born residents which make up nearly half of the noncitizen foreign-born population [17, 18]. The foreign born that are diagnosed with cancer are often diagnosed at later stages which puts a greater financial burden on the health care system and reduces life expectancy [19, 20]. …”