|Title||Neighborhood socio-economic disadvantage and race/ethnicity as predictors of breast cancer stage at diagnosis.|
|Publication Type||Journal Article|
|Year of Publication||2013|
|Authors||Flores, YN, Davidson, PL, Nakazono, TT, Carreon, DC, Mojica, CM, Bastani, R|
|Journal||BMC Public Health|
|Keywords||Adult, Breast Neoplasms, California, Continental Population Groups, Delayed Diagnosis, Educational Status, Ethnic Groups, Female, Healthcare Disparities, Humans, Income, Middle Aged, Neoplasm Staging, Poverty, Residence Characteristics, Socioeconomic Factors|
BACKGROUND: This study investigated the role of key individual- and community-level determinants to explore persisting racial/ethnic disparities in breast cancer stage at diagnosis in California during 1990 and 2000.
METHODS: We examined socio-demographic determinants and changes in breast cancer stage at diagnosis in California during 1990 and 2000. In situ, local, regional, and distant diagnoses were examined by individual (age, race/ethnicity, and marital status) and community (income and education by zip code) characteristics. Community variables were constructed using the California Cancer Registry 1990-2000 and the 1990 and 2000 U.S. Census.
RESULTS: From 1990 to 2000, there was an overall increase in the percent of in situ diagnoses and a significant decrease in regional and distant diagnoses. Among white and Asian/Pacific Islander women, a significant percent increase was observed for in situ diagnoses, and significant decreases in regional and distant diagnoses. Black women had a significant decrease in distant -stage diagnoses, and Hispanic women showed no significant changes in any diagnosis during this time period. The percent increase of in situ cases diagnosed between 1990 and 2000 was observed even among zip codes with low income and education levels. We also found a significant percent decrease in distant cases for the quartiles with the most poverty and least education.
CONCLUSIONS: Hispanic women showed the least improvement in breast cancer stage at diagnosis from 1990 to 2000. Breast cancer screening and education programs that target under-served communities, such as the rapidly growing Hispanic population, are needed in California.
|Alternate Journal||BMC Public Health|
|PubMed Central ID||PMC3831816|
|Grant List||R25 CA087949 / CA / NCI NIH HHS / United States |
P30 CA054174 / CA / NCI NIH HHS / United States