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13.04.2023 | Epidemiology

Racial/ethnic and socioeconomic differences in breast cancer surgery performed and delayed treatment: mediating impact on mortality

verfasst von: Pierre Fwelo, Kenechukwu O. S. Nwosu, Toluwani E. Adekunle, Oladipo Afolayan, Onyekachi Ahaiwe, Akpevwe A. Ojaruega, Vignesh K. Nagesh, Ayrton Bangolo

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 3/2023

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Abstract

Objective

Although Socioeconomic status (SES), race/ethnicity, surgical type, and treatment delays are associated with breast cancer mortality outcomes, studies on these associations have been contrasting. This study examined the racial/ethnic and SES differences in surgical treatment types and treatment delays. Also, we quantified the extent to which these differences explained the racial/ethnic disparities in breast cancer mortality.

Methods

We studied 290,066 women 40 + years old diagnosed with breast cancer between 2010 and 2017 identified from the Surveillance, Epidemiology, and End Results database. We performed logistic regression models to examine the association of SES and race/ethnicity with surgical treatment type and treatment delays. We performed mediation analysis models to quantify the extent to which mortality differences were mediated by treatment, sociodemographic, and clinicopathologic factors.

Results

Non-Hispanic (NH) Black [Odds ratio (OR) = 1.16, 95% CI 1.13–1.19] and Hispanic women [OR = 1.27, 95% CI 1.24–1.31] were significantly more likely to undergo mastectomy compared to NH White women. Similarly, NH Black and Hispanic women had higher odds of delayed treatment than NH Whites. Patients in the highest SES quintile, compared to those in lowest the lowest, were less likely to experience breast cancer-specific mortality (BCSM). Variations in treatment, SES, and clinicopathological factors significantly explained 70% of the excess BCSM among NH Blacks compared to their NH White counterparts.

Conclusions

Bridging the gap of access to adequate healthcare services for all to diminish the disproportionate burden of breast cancer would require a multifactorial approach that addresses several biological and social factors that cause these differences.

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Titel: Racial/ethnic and socioeconomic differences in breast cancer surgery performed and delayed treatment: mediating impact on mortality
verfasst von: Pierre Fwelo
Kenechukwu O. S. Nwosu
Toluwani E. Adekunle
Oladipo Afolayan
Onyekachi Ahaiwe
Akpevwe A. Ojaruega
Vignesh K. Nagesh
Ayrton Bangolo
Publikationsdatum: 13.04.2023
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 3/2023
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-023-06941-z

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Racial/ethnic and socioeconomic differences in breast cancer surgery performed and delayed treatment: mediating impact on mortality