Characteristics Associated With Differences in Survival Among Black and White Women With Breast Cancer

IMPORTANCE Difference in breast cancer survival by race is a recognized problem among Medicare beneficiaries. OBJECTIVE To determine if racial disparity in breast cancer survival is primarily attributable to differences in presentation characteristics at diagnosis or subsequent treatment. DESIGN, SE...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2013-07, Vol.310 (4), p.389-397
Main Authors: Silber, Jeffrey H, Rosenbaum, Paul R, Clark, Amy S, Giantonio, Bruce J, Ross, Richard N, Teng, Yun, Wang, Min, Niknam, Bijan A, Ludwig, Justin M, Wang, Wei, Even-Shoshan, Orit, Fox, Kevin R
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Black or African American
Black People - statistics & numerical data
Breast cancer
Breast Neoplasms - ethnology
Breast Neoplasms - mortality
Breast Neoplasms - therapy
Case-Control Studies
Female
General aspects
Gynecology. Andrology. Obstetrics
Health Status Disparities
Healthcare Disparities
Humans
Mammary gland diseases
Mammography
Medical diagnosis
Medical sciences
Medical treatment
Medicare - statistics & numerical data
Mortality
Multiple tumors. Solid tumors. Tumors in childhood (general aspects)
Racial differences
SEER Program - statistics & numerical data
Survival Analysis
Tumors
United States
White People - statistics & numerical data
Women
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Summary:IMPORTANCE Difference in breast cancer survival by race is a recognized problem among Medicare beneficiaries. OBJECTIVE To determine if racial disparity in breast cancer survival is primarily attributable to differences in presentation characteristics at diagnosis or subsequent treatment. DESIGN, SETTING, AND PATIENTS Comparison of 7375 black women 65 years and older diagnosed between 1991 to 2005 and 3 sets of 7375 matched white control patients selected from 99 898 white potential controls, using data for 16 US Surveillance, Epidemiology and End Results (SEER) sites in the SEER-Medicare database. All patients received follow-up through December 31, 2009, and the black case patients were matched to 3 white control populations on demographics (age, year of diagnosis, and SEER site), presentation (demographics variables plus patient comorbid conditions and tumor characteristics such as stage, size, grade, and estrogen receptor status), and treatment (presentation variables plus details of surgery, radiation therapy, and chemotherapy). MAIN OUTCOMES AND MEASURES 5-Year survival. RESULTS The absolute difference in 5-year survival (blacks, 55.9%; whites, 68.8%) was 12.9% (95% CI, 11.5%-14.5%; P 
ISSN:0098-7484
1538-3598
1538-3598
DOI:10.1001/jama.2013.8272