Does having insurance affect differences in clinical presentation between Hispanic and non‐Hispanic white women with breast cancer?

• Published in: Cancer Vol. 109; no. 10; pp. 2093 - 2099
• Main Authors: Watlington, A. Tyler, Byers, Tim, Mouchawar, Judy, Sauaia, Angela, Ellis, Jenn
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 15.05.2007; Wiley-Liss
• Subjects: Adult; Biological and medical sciences; biology; breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - ethnology; Breast Neoplasms - pathology; clinical presentation; Colorado; equal access; European Continental Ancestry Group; Female; Gynecology. Andrology. Obstetrics; Health Services Accessibility; Hispanic; Humans; insurance; Insurance, Health; Mammary gland diseases; Medical sciences; Mexican Americans; Middle Aged; Socioeconomic Factors; tumor characteristics; Tumors; Colorado; Human; insurance; Accessibility; equal access; tumor characteristics; Biology; Breast cancer; Malignant tumor; Latinamerican; Mammary gland diseases; Cancerology; clinical presentation; Adult; Female; Caucasoid; Woman; Hispanic
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.22640

BACKGROUND Hispanic women with breast cancer present differently than do non‐Hispanic white (NHW) women. Lack of access to care has been offered as an explanation for these differences. In this study breast cancer presentation was examined in Hispanic women in a comprehensive, equal‐access health care system. METHODS Hispanic and NHW breast cancer cases registered between 1995 and 2004 in the Kaiser Permanente of Colorado Tumor Registry were compared by age at diagnosis, stage, tumor grade, size, and receptor status. Multivariate logistic regression was performed to generate age‐adjusted odds ratios by ethnicity and each tumor characteristic. RESULTS A total of 139 Hispanic women and 2118 NHW women with breast cancer were identified. Hispanic women had a mean average age at diagnosis of 56 years compared with 61 years for NHW women (P < .0001). Use of mammographic screening services in the prior 2 years was similar by ethnicity. Relative to NHW women, Hispanic women had age‐adjusted odds ratios of 2.70 (95% confidence interval [CI]: 1.26–5.77) for having stage IV disease, 2.25 (95% CI: 1.39–3.67) for having poorly differentiated tumors, 2.16 (95% CI: 1.26–3.69) for having a tumor greater than 5 cm, and 1.88 (95% CI: 1.24–2.81) for having estrogen receptor‐negative tumors. CONCLUSIONS Despite equal access to health care services, differences persist in the size, stage, and grade of breast cancer for Hispanic women compared with NHW women. The results of the study suggest a biologic/genetic basis for these differences. Cancer 2007. © 2007 American Cancer Society. Differences in clinical presentation with breast cancer for Hispanic women compared with non‐Hispanic white women persist despite membership in a comprehensive, equal‐access health care system.