title: Policy implications of early onset breast cancer among Mexican-origin women.
abstract: BACKGROUND
  Overall, Latinas are more likely to be diagnosed with a more advanced stage of breast cancer and are 20% more likely to die of breast cancer than non-Hispanic white women. It is estimated that from 2003 to 2006, $82.0 billion in direct medical care expenditures, in addition to 100,000 lives annually, could be saved by eliminating health disparities experienced by Latinos and increasing the use of up to 5 preventive services in the United States. An additional 3700 lives could be saved if 90% of women aged ≥40 years were recently screened for breast cancer.
  
  
  METHODS
  The authors examined the risk for breast cancer in a case-control, population-based sample of Mexican-origin women in Harris County, Texas (n=714), where the rates of breast cancer mortality for Latina women have doubled since 1990.
  
  
  RESULTS
  Half of breast cancer cases (n=119) were diagnosed in women aged <50 years. In a multivariate model, women who had a family history of breast cancer (odds ratio [OR], 4.3), who were born in Mexico and had high levels of language acculturation (OR, 2.5), and who did not have health insurance (OR, 1.6) had the highest risk for breast cancer.
  
  
  CONCLUSIONS
  Because the current results indicated that Mexican-origin women are at high-risk for early onset, premenopausal breast cancer, the authors recommended policies that target screening, education, and treatment to prevent increased disparities in mortality. The authors concluded that the inclusion of community members and policymakers as partners in these endeavors would further safeguard against an increase in cancer health disparities and aid in formulating a policy agenda congruent with scientifically based, community-driven policy efforts that address breast cancer screening, education, and treatment in this vulnerable population.
authors.affiliation: Department of Health Disparities Research, The University of Texas M. D. Anderson Cancer Center, PO Box 301402-Unit 639, Houston, TX 77230-1402, USA. pymiranda@mdanderson.org
authors.forename: Patricia Y
authors.initials: PY
authors.lastname: Miranda
authors.forename: Anna V
authors.initials: AV
authors.lastname: Wilkinson
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Etzel
authors.forename: Renke
authors.initials: R
authors.lastname: Zhou
authors.forename: Lovell A
authors.initials: LA
authors.lastname: Jones
authors.forename: Patricia
authors.initials: P
authors.lastname: Thompson
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Bondy
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000517:prevention & control*; D055088:Early Detection of Cancer; D005192:Family Health; D005260:Female; D015438:Health Behavior; D006266:Health Education; D006291:Health Policy; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D017058:Mexican Americans; D008875:Middle Aged; D017697:Premenopause; D011315:Preventive Medicine; D012306:Risk; D012959:Socioeconomic Factors; D014481:United States