title: Breast cancer survival of Hispanic women in the USA is influenced by country of origin.
abstract: OBJECTIVE
  People of Hispanic origin comprise nearly 16 percent of the (US) population. With the growing population of Hispanics in the USA, an important epidemiological question is whether their country of origin affects survival in Hispanic women living in the USA at the time of diagnosis of breast cancer.
  
  
  METHODS
  We searched the Surveillance Epidemiology and End Results (SEER) database for Hispanic women with a single primary breast cancer with known country of origin diagnosed between 1973 and 2008. Univariate and multivariate analyses were performed to evaluate whether the country of origin was an independent predictor of survival.
  
  
  RESULTS
  In total, 48,849 female breast cancer patients of Hispanic origin were included in the SEER database. Nearly 23 percent of them had an origin in Mexico, 9 percent in South or Central America 3 percent in Puerto Rico, 2 percent in Cuba, 0.3 percent in the Dominical Republic and 3 percent in other countries, including Europe. About 60 percent of patients were identified as Hispanic by their surname or classified as Spanish/Hispanic not otherwise specified. Median survival of patients in these groups was 204, 240, 142, 169, 82.4, 115.5 and 210 months, respectively (P < 0.0001 by log-rank test). Univariate and multivariate analysis showed that the country of origin was an independent predictor of survival in Hispanic women with breast cancer.
  
  
  CONCLUSIONS
  The country of origin is an independent predictor of overall survival among Hispanic women diagnosed with breast cancer.
authors.affiliation: Department of Internal Medicine, College of Public Health, Omaha, Nebraska, USA.
authors.forename: Subhankar
authors.initials: S
authors.lastname: Chakraborty
authors.forename: Lynette
authors.initials: L
authors.lastname: Smith
authors.forename: Apar Kishor
authors.initials: AK
authors.lastname: Ganti
authors.forename: Neelima
authors.initials: N
authors.lastname: Bonthu
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Shimizhu
authors.forename: Surinder K
authors.initials: SK
authors.lastname: Batra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology / Q000208:ethnology* / Q000401:mortality* / Q000473:pathology; D002489:Central America / Q000208:ethnology; D003462:Cuba / Q000208:ethnology; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011647:Puerto Rico / Q000208:ethnology; D018426:SEER Program; D013020:South America / Q000208:ethnology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Hispanic; Latino; Spanish; breast cancer
references.citation: J Natl Med Assoc. 2004 May;96(5):598-608
references.pmid: 15160974
references.citation: Cancer. 2002 Jun 1;94(11):2801-12
references.pmid: 12115366
references.citation: Womens Health Issues. 2002 May-Jun;12(3):122-8
references.pmid: 12015184
references.citation: Health Soc Work. 2006 Feb;31(1):36-43
references.pmid: 16550846
references.citation: JAMA. 2007 Dec 26;298(24):2869-76
references.pmid: 18159056
references.citation: Am J Public Health. 1999 Feb;89(2):219-27
references.pmid: 9949753
references.citation: Cancer Epidemiol Biomarkers Prev. 2010 May;19(5):1208-18
references.pmid: 20447917
references.citation: CA Cancer J Clin. 2011 Nov-Dec;61(6):409-18
references.pmid: 21969133
references.citation: Arch Intern Med. 2003 Jan 13;163(1):49-56
references.pmid: 12523916
references.citation: Fam Cancer. 2008;7(3):275-9
references.pmid: 18286383
references.citation: Breast Cancer Res. 2005;7(6):R1090-6
references.pmid: 16457689
references.citation: Health Psychol. 2001 Jan;20(1):41-6
references.pmid: 11199065
references.citation: Hum Mutat. 2003 Oct;22(4):301-12
references.pmid: 12955716