Color or money?: The impact of socioeconomic status and race/ethnicity on breast cancer mortality

• Published in: The American journal of surgery Vol. 224; no. 6; pp. 1403 - 1408
• Main Authors: Nnorom, Siobhan O., Akinyemi, Oluwasegun, Tran, Joseph, Baig, Hana, Cornwell, Edward E., Frederick, Wayne A., Wilson, Lori L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2022; Elsevier Limited
• Subjects: Breast cancer; Breast Neoplasms; Disparity; Ethnicity; Female; Humans; Incidence; Minority & ethnic groups; Mortality; Proportional Hazards Models; Prosperity; Quartiles; Race; Race/ethnicity; Social Class; Socioeconomic; Socioeconomic factors; Socioeconomic status; Socioeconomics; Survival; United States > US; Alaska; Socioeconomic; Breast cancer; Disparity; Race/ethnicity; Survival; Mortality
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2022.07.013

Although the incidence of breast cancer is highest in White women, Black women die at a higher rate. Our aim was to compare the relative association between race/ethnicity and socioeconomic status on breast cancer mortality. We identified female breast cancer patients diagnosed between 2007 - 2011 and followed through 2016 in the SEER database. Patients were grouped into socioeconomic quartiles by a prosperity index. The primary outcome of interest was 5-year cancer-specific survival. A total of 286,520 patients were included. Five-year survival was worst for Black women compared to other races/ethnicities in each socioeconomic quartile. When compared to White women in the lowest quartile, Black women in the lowest quartile, 2nd quartile, and 3rd quartile experienced the lowest 5-year survival rates (Hazard ratio 1.33, 1.23, 1.20; P < 0.01). Regarding cancer mortality, only in the most prosperous quartile do Black women achieve a similar outcome to the poorest quartile White women. •Mortality is worst in Black females regardless of socioeconomic or insurance status.•Only in the richest quartile did Blacks have survival like Whites in the poorest.•Outcome disparities improved with higher socioeconomic status.