Breast Cancer Diagnoses, Survival Varies by Race, Ethnicity

The gist: A recent study found that a breast cancer patient’s race and ethnicity might affect whether they are diagnosed at an early stage. Race and ethnicity might also affect how long a patient survives after a stage I diagnosis.

“Among nearly 375,000 U.S. women diagnosed with invasive breast cancer, the likelihood of diagnosis at an early stage, and survival after stage I diagnosis, varied by race and ethnicity, with much of the difference accounted for by biological differences, according to a study in the January 13 issue of JAMA.

“In the United States, incidence rates of breast cancer among women vary substantially by racial/ethnic group. Race/ethnicity and sociodemographic factors may influence a woman’s adherence to recommendations for clinical breast examination, breast self-examination, or screening mammogram and the likelihood of her seeking appropriate care in the event that a breast mass is noticed. A growing body of evidence suggests that biological factors may also be important in determining stage at diagnosis (i.e., the growth rate and metastatic potential of small-sized breast cancer tumors may vary between women due to inherent differences in grade and other or unknown pathological features), according to background information in the article…

“The authors write that much of the difference in diagnosis and survival could be statistically accounted for by intrinsic biological differences such as lymph node metastasis, distant metastasis, and triple-negative behavior of tumors…

” ‘Access to the use of genetic or molecular markers to guide choice of targeted therapy and reduce the costs of care can be made more equitable. For women with triple-negative disease, access to prompt diagnosis and initiation of chemotherapy can be lifesaving because these tumors metastasize early. Closing the survival gap will only occur once health care leaders initiate system changes that improve access to high-quality care along with a more comprehensive study of breast cancer biology through inclusion of a substantial number of minority patients in ‘omics’ research and in clinical trials.’ “

Minorities With Cancer Not Using High-Volume Hospitals

The gist: Cancer patients often have better survival rates if they go to high-volume hospitals (hospitals that give a lot of treatments). However, a new study finds that ethnic minorities don’t use high-volume hospitals in the U.S. as much as white patients.

“Cancer patients from an ethnic minority don’t use high-volume hospitals in the United States as much as white patients, even though they live just as close, a new study shows. Socioeconomic factors, such as poverty and education level, could contribute to this difference.

“This is important because ethnic minorities fare worse after diagnosis with many diseases, said first author Lyen Huang, MD, a research fellow at Stanford University in California. For example, 65.6% of white patients live 5 years after a diagnosis of colorectal cancer, compared with 55.5% of black patients.

” ‘We know that high-volume hospitals are associated with decreased mortality rates after cancer, but minorities are less likely to use these hospitals,’ Dr Huang said here at the American College of Surgeons 2014 Clinical Congress.

“To understand why members of ethnic minorities are less likely to use high-volume hospitals, Dr Huang and his colleagues linked data from the California Cancer Registry with statewide hospital discharge abstracts. They looked for patients treated for colorectal cancer from 1996 to 2006.”

Genetics, age and ethnicity are risk factors in prostate cancer, say experts

Genetics, age and ethnicity are risk factors for prostate cancer, while the evidence for obesity, smoking and diabetes as associated risks remains uncertain, according to prostate cancer experts.