Racial Differences in Survival From Breast Cancer

Eley, J. William; Hill, Holly A.; Chen, Vivien W.; Austin, Donald F.; Wesley, Margaret N.; Muss, Hyman B.; Greenberg, Raymond S.; Coates, Ralph J.; Correa, Pelayo; Redmond, Carol; Hunter, Carrie P.; Herman, Allen; Kurman, Robert J.; Blacklow, Robert S.; Shapiro, Sam; Edwards, Brenda K.

doi:10.1001/jama.1994.03520120057031

Cited by 430 publications

(75 citation statements)

References 22 publications

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“…In a study of American Indians who were registered with the Indian Health some sites, but not all, the disparity is explained by differences in the distribution of stage at diagnosis and Service in Montana, relative survival was significantly lower for American Indians than for whites in the U.S. 1 access to medical care. 5,26,28 For breast and prostate carcinoma, ethnicity-related differences in socioecoSurvival was similar for American Indian residents of New Mexico and Montana. We are not aware of any nomic variables and measures of access to care appear to influence survival through stage at diagnosis.…”

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confidence: 95%

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Trends in the survival of american indian, hispanic, and non‐hispanic white cancer patients in new mexico and arizona, 1969‐1994

Gilliland

Hunt

Key

1998

Cancer

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Increased cancer control efforts were associated with earlier diagnosis, more patients receiving appropriate therapy, and improved survival for non-Hispanic whites, American Indians, and Hispanics. However, the improvement was greatest for non-Hispanic whites, and disparities in survival results for the different ethnic groups widened over the period of study. Cancer control strategies need to address the specific social, cultural, and biologic prognostic factors that affect different ethnic groups if disparities in outcomes are to be reduced.

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confidence: 95%

“…We are not aware of any nomic variables and measures of access to care appear to influence survival through stage at diagnosis. 26,28 studies that examined temporal trends in survival for American Indians. However, because the disparity in breast carcinoma survival for African Americans is not fully explained…”

mentioning

confidence: 99%

Trends in the survival of american indian, hispanic, and non‐hispanic white cancer patients in new mexico and arizona, 1969‐1994

Gilliland

Hunt

Key

1998

Cancer

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“…In several studies that used administrative data, as well as medical record review, African-American patients were found to have lower utilization of diagnostic and therapeutic procedures. Whereas most analyses have been limited to cardiac catheterization, coronary angioplasty, and coronary bypass grafting, [1][2][3][4]6,7 others have reported less frequent surgical intervention for African-American patients with colorectal cancer, 12 breast cancer, 13,14 and bladder cancer, 15 as well as lower rates of outpatient preventive services. 16,17 Although the concept of race is somewhat tenuous and may be a surrogate for socioeconomic status, 18 two reports from the Veterans Administration have demonstrated lower rates of cardiovascular procedures in African Americans, 2,3 suggesting that social and clinical factors are also important.…”

Section: Discussionmentioning

confidence: 99%

“…[13][14][15] In contrast, others have not demonstrated racial disparity in survival despite differential treatment of cardiac procedures, 3 and seriously ill patients. 19,20 Moreover, a recent study that included a greater level of clinical detail, as well as disease-specific severity adjustment, reported similar or even lower mortality rates for African-American patients with six common medical diagnoses.…”

Section: Discussionmentioning

confidence: 99%

Lack of gender and racial differences in surgery and mortality in hospitalized medicare beneficiaries with bleeding peptic ulcer

et al. 1997

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OBJECTIVE: Determine the relation of race and gender to outcome from bleeding peptic ulcer. DESIGN:Retrospective cohort study. SETTING:All acute care hospitals in the United States.PATIENTS: A 100% sample of hospitalized Medicare beneficiaries older than 64 years ( n ‫؍‬ 82,868) with a primary discharge diagnosis of peptic ulcer with hemorrhage. MEASUREMENTS AND MAIN RESULTS:Surgical treatment was performed in 6.9% of patients, 30-day mortality was 8.5%, and average length of stay was 9.4 days. Surgery was somewhat more common in men than women (7.3% vs 6.5%, p Ͻ .001), and in whites than African Americans (6.9% vs 6.3%, p Ͻ .001), but neither race nor gender was associated with surgery in multivariable analysis adjusting for potentially confounding factors. Mortality rates were similar in African Americans and whites (8.5%), and somewhat higher in men than women (10.7% vs 9.3%, p Ͻ .001). In multivariable analysis, there was no difference in mortality across gender and racial groups. Although unadjusted and adjusted lengths of stay were longer for African Americans and shorter for men, the differences were modest (i.e., 16% increase and 6% decrease in multivariable analysis, respectively, p Ͻ .0001). CONCLUSIONS:In this national sample, there is no significant gender or racial difference in therapy and outcome for patients with hemorrhagic peptic ulcer. The findings raise the possibility that studies that have shown race and gender differences in management of coronary artery disease and cancer may not be generalizable to other common diagnoses.KEY WORDS: peptic ulcer; African Americans; women; Medicare.

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“…Racial differences on such tumor characteristics as hormone receptors have implicated gene-based causal pathways [10,11], but their ability to account for racial group survival differences has ranged widely [12][13][14][15][16]. As managed care proliferated and the prevalence of uninsured Americans increased over the past 25 years [17][18][19][20][21][22][23][24], a health insurance theory has been advanced to explain social, including racial, cancer survival gradients [25][26][27][28].…”

Section: Introductionmentioning

confidence: 99%

Increased racial differences on breast cancer care and survival in America: historical evidence consistent with a health insurance hypothesis, 1975–2001

Gorey

Luginaah

Schwartz

et al. 2008

Breast Cancer Res Treat

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Purpose-This study examined whether race/ethnicity had differential effects on breast cancer care and survival across age strata and cohorts within stages of disease. Methods-TheDetroit Cancer Registry provided 25,997 breast cancer cases. African American and non-Hispanic white, older Medicare-eligible and younger non-eligible women were compared. Successive historical cohorts (1975-1980 and 1990-1995) CIHR Author Manuscript CIHR Author Manuscript CIHR Author ManuscriptResults-African American disadvantages on survival and treatments increased significantly, particularly among younger women who were much more likely to be uninsured. Within node positive disease all treatment disadvantages among younger African American women disappeared with socioeconomic adjustment.Conclusions-Growth of this racial divide implicates social, rather than biological, forces. Its elimination will require high quality health care for all.

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Racial Differences in Survival From Breast Cancer

Cited by 430 publications

References 22 publications

Trends in the survival of american indian, hispanic, and non‐hispanic white cancer patients in new mexico and arizona, 1969‐1994

Trends in the survival of american indian, hispanic, and non‐hispanic white cancer patients in new mexico and arizona, 1969‐1994

Lack of gender and racial differences in surgery and mortality in hospitalized medicare beneficiaries with bleeding peptic ulcer

Increased racial differences on breast cancer care and survival in America: historical evidence consistent with a health insurance hypothesis, 1975–2001

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