TY - JOUR
T1 - Exploring the intersectionality of race/ethnicity with rurality on breast cancer outcomes
T2 - SEER analysis, 2000–2016
AU - Moore, Justin Xavier
AU - Andrzejak, Sydney Elizabeth
AU - Jones, Samantha
AU - Han, Yunan
N1 - Funding Information:
Dr. Moore was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number K01MD015304. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2022, The Author(s).
PY - 2023/2
Y1 - 2023/2
N2 - Purpose: Disparities in breast cancer survival have been observed within marginalized racial/ethnic groups and within the rural–urban continuum for decades. We examined whether there were differences among the intersectionality of race/ethnicity and rural residence on breast cancer outcomes. Methods: We performed a retrospective analysis among 739,448 breast cancer patients using Surveillance Epidemiology and End Results (SEER) 18 registries years 2000 through 2016. We conducted multilevel logistic-regression and Cox proportional hazards models to estimate adjusted odds ratios (AORs) and hazard ratios (AHRs), respectively, for breast cancer outcomes including surgical treatment, radiation therapy, chemotherapy, late-stage disease, and risk of breast cancer death. Rural was defined as 2013 Rural–Urban Continuum Codes (RUCC) of 4 or greater. Results: Compared with non-Hispanic white–urban (NH-white–U) women, NH-black–U, NH-black–rural (R), Hispanic–U, and Hispanic–R women, respectively, were at increased odds of no receipt of surgical treatment (NH-black–U, AOR = 1.98, 95% CI 1.91–2.05; NH-black–R, AOR = 1.72, 95% CI 1.52–1.94; Hispanic–U, AOR = 1.58, 95% CI 1.52–1.65; and Hispanic–R, AOR = 1.40, 95% CI 1.18–1.67), late-stage diagnosis (NH-black–U, AOR = 1.32, 95% CI 1.29–1.34; NH-black–R, AOR = 1.29, 95% CI 1.22–1.36; Hispanic–U, AOR = 1.25, 95% CI 1.23–1.27; and Hispanic–R, AOR = 1.17, 95% CI 1.08–1.27), and increased risks for breast cancer death (NH-black–U, AHR = 1.46, 95% CI 1.43–1.50; NH-black–R, AHR = 1.42, 95% CI 1.32–1.53; and Hispanic–U, AHR = 1.10, 95% CI 1.07–1.13). Conclusion: Regardless of rurality, NH-black and Hispanic women had significantly increased odds of late-stage diagnosis, no receipt of treatment, and risk of breast cancer death.
AB - Purpose: Disparities in breast cancer survival have been observed within marginalized racial/ethnic groups and within the rural–urban continuum for decades. We examined whether there were differences among the intersectionality of race/ethnicity and rural residence on breast cancer outcomes. Methods: We performed a retrospective analysis among 739,448 breast cancer patients using Surveillance Epidemiology and End Results (SEER) 18 registries years 2000 through 2016. We conducted multilevel logistic-regression and Cox proportional hazards models to estimate adjusted odds ratios (AORs) and hazard ratios (AHRs), respectively, for breast cancer outcomes including surgical treatment, radiation therapy, chemotherapy, late-stage disease, and risk of breast cancer death. Rural was defined as 2013 Rural–Urban Continuum Codes (RUCC) of 4 or greater. Results: Compared with non-Hispanic white–urban (NH-white–U) women, NH-black–U, NH-black–rural (R), Hispanic–U, and Hispanic–R women, respectively, were at increased odds of no receipt of surgical treatment (NH-black–U, AOR = 1.98, 95% CI 1.91–2.05; NH-black–R, AOR = 1.72, 95% CI 1.52–1.94; Hispanic–U, AOR = 1.58, 95% CI 1.52–1.65; and Hispanic–R, AOR = 1.40, 95% CI 1.18–1.67), late-stage diagnosis (NH-black–U, AOR = 1.32, 95% CI 1.29–1.34; NH-black–R, AOR = 1.29, 95% CI 1.22–1.36; Hispanic–U, AOR = 1.25, 95% CI 1.23–1.27; and Hispanic–R, AOR = 1.17, 95% CI 1.08–1.27), and increased risks for breast cancer death (NH-black–U, AHR = 1.46, 95% CI 1.43–1.50; NH-black–R, AHR = 1.42, 95% CI 1.32–1.53; and Hispanic–U, AHR = 1.10, 95% CI 1.07–1.13). Conclusion: Regardless of rurality, NH-black and Hispanic women had significantly increased odds of late-stage diagnosis, no receipt of treatment, and risk of breast cancer death.
KW - Breast cancer
KW - Cancer
KW - Disparities
KW - Race
KW - Rural/urban
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U2 - 10.1007/s10549-022-06830-x
DO - 10.1007/s10549-022-06830-x
M3 - Article
C2 - 36520228
AN - SCOPUS:85144022688
SN - 0167-6806
VL - 197
SP - 633
EP - 645
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
IS - 3
ER -