Race, anthropometric factors, and stage at diagnosis of breast cancer.
A recent study suggested that the greater prevalence of severe obesity among African-American women explained almost one third of the observed differences between African-American and White women in stage at diagnosis of breast cancer. The objective of this investigation was to attempt to replicate these findings in a second, larger population and to expand the analyses by including a measure of body fat distribution, the waist:hip ratio. The authors used data from a population-based study in North Carolina comprising 791 breast cancer cases (302 in African-American women and 489 in White women) diagnosed between 1993 and 1996. African-American women were more likely to have later-stage (TNM stage >/=II) breast cancer (odds ratio (OR) = 2.2; 95% confidence interval (CI): 1.6, 2.9). They also were much more likely to be severely obese (body mass index >/=32.3) (OR = 9.7; 95% CI: 6.5, 14.5) and to be in the highest tertile of waist:hip ratio (OR = 5.7; 95% CI: 3.8, 8.6). In multivariate logistic regression models, adjustment for waist:hip ratio reduced the odds ratio for later-stage disease in African-American women by 20%; adjustment for both waist:hip ratio and severe obesity reduced the odds ratio by 27%. These observations suggest that obesity and body fat distribution, in addition to socioeconomic and medical care factors, contribute to racial differences in stage at breast cancer diagnosis.
Moorman
P G
PG
Department of Epidemiology and Public Health, School of Medicine, Yale University, New Haven, CT, USA. patricia.moorman@duke.edu
Jones
B A
BA
Millikan
R C
RC
Hall
I J
IJ
Newman
B
B
D044383:Black People; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000473:pathology; D016022:Case-Control Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008327:Mammography / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009657:North Carolina / Q000453:epidemiology; D009765:Obesity / Q000208:ethnology*; D016017:Odds Ratio; D012959:Socioeconomic Factors; D044465:White People; D001741:Black or African American