Although breast cancer survival has improved over the last 30 years, disparities in breast cancer survival between blacks and whites have not declined and remain sizeable, according to background information in the article. The 5-year U.S. survival rates in 1995-2000 for black and white breast cancer patients were 75 percent and 89 percent, respectively. Although several causes have been identified, such as advanced cancer stage, lack of access to medical care, inferior treatment, and lower socioeconomic status (SES), not all reasons for this disparity are understood.
C. Martin Tammemagi, Ph.D., of Brock University, St. Catharines, Ontario, Canada and colleagues evaluated data from breast cancer patients to evaluate the associations between adverse comorbidities (co-existing illnesses) and racial survival disparity. A group of patients (n = 906) from the Henry Ford Health System (a large comprehensive health system in Detroit) were followed up for a median of 10 years. Patients included 264 black (29.1 percent) women and 642 white (70.9 percent) women diagnosed as having breast cancer between 1985 and 1990. Detailed comorbidity data (268 comorbidities) and study data were abstracted from various medical records, databases and registries.
A total of 159 blacks (61.9 percent) and 317 whites (50.4 percent) died. Overall, 62.4 percent of deaths were attributed to competing causes. Proportionately more blacks than whites died of breast cancer (64 [24.9 percent] vs. 115 [18.3 percent]) and of competing causes (95 [37.0 percent] vs. 202 [32.1 percent]). Compared with whites, blacks had shorter overall survival (34 percent more likely), breast cancerspecific survival (47 percent more likely to have shorter survival), and comp
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JAMA and Archives Journals