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https://hdl.handle.net/2440/66599
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Type: | Journal article |
Title: | Trends in Area-Socioeconomic and Race-Ethnic Disparities in Breast Cancer Incidence, Stage at Diagnosis, Screening, Mortality, and Survival among Women Ages 50 Years and Over (1987-2005) |
Author: | Harper, S. Lynch, J. Meersman, S. Breen, N. Davis, W. Reichman, M. |
Citation: | Cancer Epidemiology, Biomarkers and Prevention, 2009; 18(1):121-131 |
Publisher: | Amer Assoc Cancer Research |
Issue Date: | 2009 |
ISSN: | 1055-9965 1538-7755 |
Statement of Responsibility: | Sam Harper, John Lynch, Stephen C. Meersman, Nancy Breen, William W. Davis, and Marsha C. Reichman |
Abstract: | <h4>Background</h4>Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer death among women in the United States and varies systematically by race-ethnicity and socioeconomic status. Previous research has often focused on disparities between particular groups, but few studies have summarized disparities across multiple subgroups defined by race-ethnic and socioeconomic position.<h4>Methods</h4>Data on breast cancer incidence, stage, mortality, and 5-year cause-specific probability of death (100 - survival) were obtained from the Surveillance, Epidemiology, and End Results program and data on mammography screening from the National Health Interview Survey from 1987 to 2005. We used four area-socioeconomic groups based on the percentage of poverty in the county of residence (<10, 10-15, 15-20, +20%) and five race-ethnic groups (White, Black, Asian, American Indian, and Hispanic). We used summary measures of disparity based on both rate differences and rate ratios.<h4>Results</h4>From 1987 to 2004, area-socioeconomic disparities declined by 20% to 30% for incidence, stage at diagnosis, and 5-year cause-specific probability of death, and by roughly 100% for mortality, whether measured on the absolute or relative scale. In contrast, relative area-socioeconomic disparities in mammography use increased by 161%. Absolute race-ethnic disparities declined across all outcomes, with the largest reduction for mammography (56% decline). Relative race-ethnic disparities for mortality and 5-year cause-specific probability of death increased by 24% and 17%, respectively.<h4>Conclusions</h4>Our analysis suggests progress towards race-ethnic and area-socioeconomic disparity goals for breast cancer, especially when measured on the absolute scale. However, greater progress is needed to address increasing relative socioeconomic disparities in mammography and race-ethnic disparities in mortality and 5-year cause-specific probability of death. |
Keywords: | Humans Breast Neoplasms Mass Screening Neoplasm Staging SEER Program Incidence Survival Analysis Age Factors Poverty Socioeconomic Factors Aged Aged, 80 and over Middle Aged United States Female Healthcare Disparities Ethnicity |
Rights: | Copyright © 2009 American Association for Cancer Research. |
DOI: | 10.1158/1055-9965.EPI-08-0679 |
Published version: | http://dx.doi.org/10.1158/1055-9965.epi-08-0679 |
Appears in Collections: | Aurora harvest 5 Public Health publications |
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