Breast cancer staging by subtype in the Lower Mississippi Delta region States |
| |
| Institution: | 1. Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, 1206 S. Fourth St., Champaign, IL, 61820 United States;2. Rural & Minority Health Research Center, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Suite 204, Columbia, SC, 29210 USA;3. North American Association of Central Cancer Registries, 2050 W. Iles Suite A, Springfield, IL, 62704, USA;4. Department of Geography and Geographic Information Science, University of Illinois Urbana-Champaign, 1301 W. Green St., Urbana, IL, 61801 USA;1. Department of Experimental Medicine, Microbiology Section, University of Study of Campania “Luigi Vanvitelli”, Via De Crecchio, 7, 80138 Naples, Italy;2. Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie, 1, 80138 Naples, Italy;1. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark;2. Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA;3. Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark;1. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;2. Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;3. Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan;1. From the SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, United States;2. Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States;3. Department of Psychosocial and Community Health, The University of Washington, Seattle, WA, United States;4. Department of Pathology, The University of Colorado Denver School of Medicine, Denver, CO, United States;5. The Cancer Therapy and Research Center, Christus Santa Rosa Medical Center, San Antonio, TX, United States;1. Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA;2. Winship Research Informatics, Emory University, Atlanta, GA, USA;1. Department of Surgery, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic;2. Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic;3. Institute of Biostatistics and Analyses, Medical Faculty, Masaryk University, Brno, Czech Republic;4. Department of Surgery, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic;5. Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic |
| |
| Abstract: | IntroductionTo evaluate disparities in breast cancer stage by subtype (categorizations of breast cancer based upon molecular characteristics) in the Delta Regional Authority (Delta), an impoverished region across eight Lower Mississippi Delta Region (LMDR) states with a high proportion of Black residents and high breast cancer mortality rates.MethodsWe used population-based cancer registry data from seven of the eight LMDR states to explore breast cancer staging (early and late) differences by subtype between the Delta and non-Delta in the LMDR and between White and Black women within the Delta. Age-adjusted incidence rates and rate ratios were calculated to examine regional and racial differences. Multilevel negative binomial regression models were constructed to evaluate how individual-level and area-level factors affect rates of early- and late-stage breast cancers by subtype.ResultsFor all subtypes combined, there were no Delta/non-Delta differences in early and late stage breast cancers. Delta women had lower rates of hormone-receptor (HR+)/human epidermal growth factor 2 (HER2-) and higher rates of HR-/HER2- (the most aggressive subtype) early and late stage cancers, respectively, but these elevated rates were attenuated in multilevel models. Within the Delta, Black women had higher rates of late-stage breast cancer than White women for most subtypes; elevated late-stage rates of all subtypes combined remained in Black women in multilevel analysis (RR = 1.10; 95% CI = 1.04–1.15).ConclusionsBlack women in the Delta had higher rates of late-stage cancers across subtypes. Culturally competent interventions targeting risk-appropriate screening modalities should be scaled up in the Delta to improve early detection. |
| |
| Keywords: | Breast cancer Triple-negative ER PR HER2 Disparities |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
