Racial Differences in Survival From Breast Cancer

摘要: Objective. —To examine the ability of recognized prognostic factors for breast cancer to account observed poorer survival in blacks compared with their white counterparts. Design and Participants. —Subjects included 1130 women (612 518 whites) aged 20 79 years residing metropolitan Atlanta, Ga, New Orleans, La, or San Francisco/Oakland, Calif, who were diagnosed primary invasive cancer. Information on stage, tumor characteristics, treatment, comorbid conditions, sociodemographic was obtained from personal interview, physician hospital records, a pathology review biopsy surgical specimens. Main Outcome Measure. —Multivariable models used estimate hazard ratio (relative risk mortality) whites, adjusting various combinations potential explanatory factors. Results. —After controlling geographic site age, dying 2.2 times (95% confidence interval [CI], 1.8 2.8) greater than whites. Adjustment stage reduced 1.7; further adjustment variables had no effect. Treatment not contributing factor once model. After illness, pathologic variables, continued demonstrate slightly increased, but statistically significant, death (hazard ratio=1.3; 95% CI, 1.0 1.8). Results similar all-cause mortality cancer—specific mortality. Conclusions. —Approximately 75% racial difference explained by studied. Sociodemographic appeared act largely through differences at diagnosis, which may be amenable change improved access use screening black women. ( JAMA . 1994;272:947-954)