The influence of race, ethnicity, and individual socioeconomic factors on breast cancer stage at diagnosis.
OBJECTIVE
Previous research has generally found that racial/ethnic differences in breast cancer stage at diagnosis attenuate when measures of socioeconomic status are included in the analysis, although most previous research measured socioeconomic status at the contextual level. This study investigated the relation between race/ethnicity, individual socioeconomic status, and breast cancer stage at diagnosis.


METHODS
Women with stage 0 to III breast cancer were identified from population-based data from the Surveillance, Epidemiology, and End Results tumor registries in the Detroit and Los Angeles metropolitan areas. These data were combined with data from a mailed survey in a sample of White, Black, and Hispanic women (n=1700). Logistic regression identified factors associated with early-stage diagnosis.


RESULTS
Black and Hispanic women were less likely to be diagnosed with early-stage breast cancer than were White women (P< .001). After control for study site, age, and individual socioeconomic factors, the odds of early detection were still significantly less for Hispanic women (odds ratio [OR]=0.45) and Black women (OR = 0.72) than for White women. After control for the method of disease detection, the White/Black disparity attenuated to insignificance; the decreased likelihood of early detection among Hispanic women remained significant (OR=0.59).


CONCLUSIONS
The way in which racial/ethnic minority status and socioeconomic characteristics produce disparities in women's experiences with breast cancer deserves further research and policy attention.
Lantz
Paula M
PM
Department of Health Management and Policy and the Institute for Social Research, University of Michigan, Ann Arbor, MI, 48109-2029, USA. plantz@umich.edu
Mujahid
Mahasin
M
Schwartz
Kendra
K
Janz
Nancy K
NK
Fagerlin
Angela
A
Salem
Barbara
B
Liu
Lihua
L
Deapen
Dennis
D
Katz
Steven J
SJ
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000208:ethnology* / Q000401:mortality; D042241:Early Diagnosis; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D015141:Los Angeles / Q000453:epidemiology; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D018426:SEER Program; D012923:Social Class; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data*