Disparities in Overall Survival for Male Breast Cancer Patients in the State of Florida (1996-2007).
BACKGROUND
Little is known regarding population-based disparities in male breast cancer (MBC). We analyzed this for Florida using data from 1996 to 2007.


METHODS
Data from the Florida Cancer Data System, the Agency for Health Care Administration, and the US Census were linked for MBC patients (n = 1589). Survival time was our primary end point, with adjustments for sociodemographic status, neighborhood-based poverty measures, clinical and hospital characteristics, and comorbidity measures based on linkage with in- and outpatient treatment records. Survival time was modeled using univariate and multivariate Cox regression models.


RESULTS
Five-year overall survival was 65.7%. Overall mean survival time in years was 7.7, but shorter in black (5.9) than white (7.8) individuals, in non-Hispanic (7.7) than Hispanic (8.5) individuals, and in the lowest socioeconomic status (SES) group (5.9) than in the highest (8.2) SES group. Patients with low SES also presented at a more advanced stage with only 75/175 [42.9%] of low SES patients who presented with localized disease compared with 311/621 [50.1%] for middle-high SES and 162/334 [48.5%] for the highest SES. Univariate hazard regressions found only the highest (hazard ratio [HR], 0.63; 95% confidence interval [CI], 0.46-0.85) and middle-high (HR, 0.71; 95% CI, 0.54-0.94) SES were at improved survival compared with lowest SES but this advantage did not remain significant in the fully adjusted model. Marital status, age, smoking status, stage, treatments, and comorbidities were also predictors of survival.


CONCLUSIONS
Survival disparities among SES groups were most apparent in our study. Improved access to screening and health care utilization might attenuate these differences. Understanding other survival disparities can aid in public health and clinical care choices.
Division of Surgical Oncology at Department of Surgery, University of Miami Miller School of Medicine, Miami, FL; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL.
Bridget
B
O'Brien
Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.
Tulay
T
Koru-Sengul
Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL.
Feng
F
Miao
Medical Education, University of Miami Miller School of Medicine, Miami, FL.
Constantine
C
Saclarides
Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL.
Stacey L
SL
Tannenbaum
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.
Hattan
H
Alghamdi
Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.
David J
DJ
Lee
Division of Surgical Oncology at Department of Surgery, University of Miami Miller School of Medicine, Miami, FL; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL.
Dido
D
Franceschi
Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.
Margaret M
MM
Byrne
Division of Surgical Oncology at Department of Surgery, University of Miami Miller School of Medicine, Miami, FL; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL. Electronic address: eavisar@med.miami.edu.
Eli
E
Avisar
D000368:Aged; D018567:Breast Neoplasms, Male / Q000453:epidemiology*; D005431:Florida / Q000453:epidemiology; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012959:Socioeconomic Factors
Cancer disparity; Ethnic factor; Florida; Male breast cancer; Social factor