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

• 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
• ISSN: 0098-7484; 1538-3598; 1538-3598
• DOI: 10.1001/jama.2013.8272

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