Eley
JW, Hill HA, Chen VW, Austin DF, Wesley MN, Muss HB, Greenberg RS, Coates
RJ, Correa P, Redmond CK, Hunter CP, Herman AA, Kurman R, Blacklow R, Shapiro
S, Edwards BK.
Racial differences in survival from breast cancer. Results of the National
Cancer Institute Black/White Cancer Survival Study.
JAMA 1994;272(12):947-54. (Comment in: JAMA. 1995 Apr 5;273(13):1000.)
“Black women experience a 5-year relative survival of only 62%,
compared with 79% for white women.”
“Black women were diagnosed at a more advanced stage of disease;
30% of blacks presented with stage III or stage IV disease compared with
18% of whites.”
“After adjusting for stage, treatment, comorbid illness, and pathologic
and demographic variables, blacks continued to demonstrate a slightly
increased, but not statistically significant, risk of death (hazard ratio=1.3;
95% CI, 1.0 to 1.8)… Approximately 75% of the racial difference
in survival was explained by the prognostic factors studied. Sociodemographic
variables appeared to act largely through racial differences in stage
at diagnosis, which may be amenable to change through improved access
to and use of screening for black women.”
“From this analysis, it is evident that reducing the survival disadvantage
for black women with breast cancer is most likely to be achieved through
strategies aimed at early recognition of disease. Future efforts should
emphasize community educational efforts, improvement in access to primary
care and mammography, and increased compliance with current screening
recommendations.”
