4.7 Article

Disparities in Primary Breast Cancer Stage at Presentation Among Hispanic Subgroups

Journal

ANNALS OF SURGICAL ONCOLOGY
Volume 29, Issue 13, Pages 7977-7987

Publisher

SPRINGER
DOI: 10.1245/s10434-022-12302-9

Keywords

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Funding

  1. Prostate Cancer Foundation (PCF)
  2. American Society for Radiation Oncology (ASTRO)
  3. Department of Defense
  4. Sylvester Comprehensive Cancer Center
  5. Center to Reduce Cancer Health Disparities, National Cancer Institute, National Institutes of Health
  6. NIH/NCI [P30 CA008748]

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This study aimed to examine the differences in breast cancer stage at presentation among the US Hispanic population. The findings showed that when disaggregated by racial subgroup and country of origin, Hispanic women were more likely to present at later-stage primary breast cancer compared to non-Hispanic White women. These disparities may be driven by socioeconomic differences as well as disparities in access and/or differential care.
Background Although the United States (US) Hispanic population consists of diverse communities, prior breast cancer studies often analyze this group in aggregate. Our aim was to identify differences in breast cancer stage at presentation in the US population, with a particular focus on Hispanic subgroups. Methods Data from the National Cancer Database (NCDB) from 2004 to 2017 were used to select women with primary breast cancer; individuals were disaggregated by racial and ethnic subgroup and Hispanic country of origin. Ordinal logistic regression was used to create adjusted odds ratios (aORs) with 95% confidence intervals (CIs), with higher odds representing presentation at later-stage breast cancer. Subgroup analysis was conducted based on tumor receptor status. Results Overall, among 2,282,691 women (5.2% Hispanic), Hispanic women were more likely to live in low-income and low-educational attainment neighborhoods, and were also more likely to be uninsured. Hispanic women were also more likely to present at later-stage primary breast cancer when compared with non-Hispanic White women (aOR 1.19, 95% CI 1.18-1.21; p < 0.01). Stage disparities were demonstrated when populations were disaggregated by country of origin, particularly for Mexican women (aOR 1.55, 95% CI 1.51-1.60; p < 0.01). Disparities worsened among both racial and country of origin subgroups in women with triple-negative disease. Conclusion Later breast cancer stage at presentation was observed among Hispanic populations when disaggregated by racial subgroup and country of origin. Socioeconomic disparities, as well as uncaptured disparities in access and/or differential care, may drive these observed differences. Future studies with disaggregated data are needed to characterize outcomes in Hispanic communities and develop targeted interventions.

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