title: Breast cancer treatment and ethnicity in British Columbia, Canada.
abstract: BACKGROUND
  Racial and ethnic disparities in breast cancer incidence, stage at diagnosis, survival and mortality are well documented; but few studies have reported on disparities in breast cancer treatment. This paper compares the treatment received by breast cancer patients in British Columbia (BC) for three ethnic groups and three time periods. Values for breast cancer treatments received in the BC general population are provided for reference.
  
  
  METHODS
  Information on patients, tumour characteristics and treatment was obtained from BC Cancer Registry (BCCR) and BC Cancer Agency (BCCA) records. Treatment among ethnic groups was analyzed by stage at diagnosis and time period at diagnosis. Differences among the three ethnic groups were tested using chi-square tests, Fisher exact tests and a multivariate logistic model.
  
  
  RESULTS
  There was no significant difference in overall surgery use for stage I and II disease between the ethnic groups, however there were significant differences when surgery with and without radiation were considered separately. These differences did not change significantly with time. Treatment with chemotherapy and hormone therapy did not differ among the minority groups.
  
  
  CONCLUSIONS
  The description of treatment differences is the first step to guiding interventions that reduce ethnic disparities. Specific studies need to examine reasons for the observed differences and the influence of culture and beliefs.
authors.affiliation: BC Cancer Agency, Vancouver, BC, Canada.
authors.forename: Parvin
authors.initials: P
authors.lastname: Yavari
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Barroetavena
authors.forename: T Greg
authors.initials: TG
authors.lastname: Hislop
authors.forename: Chris D
authors.initials: CD
authors.lastname: Bajdik
mesh_terms: D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001208:Asia / Q000208:ethnology; D044466:Asian People / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy*; D001955:British Columbia / Q000453:epidemiology; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D002681:China / Q000208:ethnology; D003466:Cultural Characteristics; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007492:Iran / Q000208:ethnology; D016015:Logistic Models; D008408:Mastectomy / Q000706:statistics & numerical data*; D008875:Middle Aged; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D018714:Radiotherapy, Adjuvant / Q000706:statistics & numerical data; D012042:Registries; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal
references.citation: Cancer. 2000 Aug 1;89(3):561-73
references.pmid: 10931455
references.citation: J Natl Cancer Inst. 1997 Sep 3;89(17):1311-2
references.pmid: 9293922
references.citation: Cancer. 2000 Jan 1;88(1):114-23
references.pmid: 10618613
references.citation: J Psychosoc Oncol. 2008;26(4):53-73
references.pmid: 19042272
references.citation: Cancer Detect Prev. 1999;23(6):463-73
references.pmid: 10571656
references.citation: Breast Cancer Res Treat. 1997 Jan;42(2):121-4
references.pmid: 9138601
references.citation: Asian Pac J Cancer Prev. 2005 Oct-Dec;6(4):455-7
references.pmid: 16435990
references.citation: Arch Intern Med. 2003 Jan 13;163(1):49-56
references.pmid: 12523916
references.citation: Cancer. 1998 Dec 15;83(12):2509-15
references.pmid: 9874456
references.citation: Acta Chir Belg. 2003 Nov-Dec;103(6):585-8
references.pmid: 14743563
references.citation: Ann Intern Med. 1998 May 1;128(9):729-36
references.pmid: 9556466
references.citation: J Natl Cancer Inst. 1994 May 4;86(9):705-12
references.pmid: 7908990
references.citation: Am J Public Health. 1997 May;87(5):775-81
references.pmid: 9184505
references.citation: Cancer Epidemiol Biomarkers Prev. 1996 Nov;5(11):861-6
references.pmid: 8922292
references.citation: Cancer. 1991 May 1;67(9):2227-34
references.pmid: 2013029
references.citation: Cancer Causes Control. 1994 Sep;5(5):440-8
references.pmid: 7999966
references.citation: Cancer Epidemiol Biomarkers Prev. 2009 Jan;18(1):121-31
references.pmid: 19124489
references.citation: J Clin Oncol. 1998 Aug;16(8):2693-9
references.pmid: 9704719
references.citation: Breast Cancer Res Treat. 1998 Jul;50(1):1-9
references.pmid: 9802615
references.citation: Cancer. 2003 May 1;97(9):2150-9
references.pmid: 12712466
references.citation: Ann Surg Oncol. 2006 Jul;13(7):977-84
references.pmid: 16788760
references.citation: Cancer. 2008 Feb 15;112(4):900-8
references.pmid: 18181101
references.citation: Crit Rev Oncol Hematol. 2006 Sep;59(3):234-42
references.pmid: 16829122
references.citation: Asian Pac J Cancer Prev. 2007 Apr-Jun;8(2):209-14
references.pmid: 17696733