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Al-Tamimi and Al-Shaman: Disparities in breast cancer by race/ethnicity among economically disadvantaged women

Introduction: It has always been thought that race influences health outcomes because of genetic factors. However, others have debated that external modifiable factors, such as socioeconomic status, are key to racial/ethnic disparities in breast cancer.

Objectives: To analyse the disparities in breast cancer (age at diagnosis, stage and type) by race and ethnicity among economically disadvantaged women in Arizona, USA.

Materials and methods: A cross-sectional study was conducted using combined data collected by Well Women Health Check Breast Cancer and Screening Program in Arizona linked with the Arizona Central Cancer Registry during the period between 1966 and July 2014. Study subjects included were breast cancer patients (n = 1151) from five different race/ethnic groups with income levels ranging between 133 and 250% of the federal poverty level. The population was divided into five different race/ethnicity categories: White, non-Hispanic and Hispanic, Black non-Hispanic, American Indian/Alaska Native, Asian/Pacific Islander. The first two race/ethnic groups constituted the majority.

Results: The sample shows a wide distribution of age at diagnosis across race/ethnicity (24 to 89 years of age), especially among Whites and Hispanics. The median age at diagnosis was 53 in almost all race/ethnic groups. Among all races, the most common type of breast cancer was invasive cancer (≈ 81%). Ductal carcinoma in situ was the most common type among each group, except for White non-Hispanic, whereby it was the least observed (~ 34%). Generally, the early stage was found more than late stage among all races (= 35%).

Conclusions: Disparities between race/ethnic groups were found. However, similarities were more prominent suggesting the strong influence of economical status on breast cancer in terms of type and age at diagnosis. Regardless of race/ethnicity, economically disadvantaged women were more likely to have breast cancer 8 years earlier than the general population.




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