Disparities across the breast cancer continuum.
OBJECTIVE
We performed a structured review of the literature to identify areas of greater and lesser knowledge of the nature of disparities across the breast cancer continuum from risk and prevention to treatment and mortality.


METHODS
We searched OvidMedline and PubMed to identify published studies from January 1990 to March 2004 that address disparities in breast cancer. We read the abstracts of the identified articles and then reviewed the articles if they were in English, were limited to American populations, limited to women, and described quantitative outcomes. We designated the articles as addressing one or more disparities across one or more of the domains of the breast cancer continuum.


RESULTS
Substantial research exists on racial disparities in breast cancer screening, diagnosis, treatment, and survival. Disparities in screening and treatment exist across other domains of disparities including age, insurance status, and socioeconomic position. Several gaps were identified including how factors interact.


CONCLUSIONS
A structured review of breast cancer disparities suggests that research in other domains of social inequality and levels of the cancer continuum may uncover further disparities. A multidisciplinary and multi-pronged approach is needed to translate the knowledge from existing research into interventions to reduce or eliminate disparities.
Bigby
Judyann
J
Department of Medicine, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA 02120, USA. jbigby@partners.org
Holmes
Michelle D
MD
D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D002986:Clinical Trials as Topic; D003937:Diagnosis, Differential; D004641:Emigration and Immigration; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007348:Insurance, Health; D008403:Mass Screening; D008875:Middle Aged; D011379:Prognosis; D044469:Racial Groups; D012307:Risk Factors; D012923:Social Class; D013534:Survival