Later diagnosis, less first-course treatment and race are the main reasons for the difference in mortality between rich and poor breast cancer patients. A new study, published in the open access journal BMC Cancer, suggests that targeted interventions to increase breast cancer screening and treatment coverage in worse-off patients could reduce much of the socioeconomic disparity in survival.
Xue Qin Yu, who conducted the analysis while employed with the American Cancer Society, studied the records of more than 112,500 women diagnosed with breast cancer in the United States between 1998 and 2002. These women were followed up until the end of 2005 and, as expected, socio-economic status (SES) was significantly associated with the likelihood of surviving. Yu said, "Women living in the lowest SES areas had the lowest percentage of early stage cancer, and the highest percentage of advanced stages, at the time of diagnosis. The proportion of black women living in the lowest SES areas was nearly four times higher than that of the highest SES areas. Furthermore, women in the lowest SES areas were significantly less likely to receive first course treatment".
Yu suggests that the unfavourable stage distribution for women from the lowest SES areas was likely caused by lower mammography rates. Lack of health insurance and lower financial resources are known to be associated with lower mammography rates and lack of, or delayed, follow-up after an abnormal mammogram. Race may be associated with breast cancer survival independent of other factors, but this study has limited ability to separate out these multiple dimensions. Finally, the observed poorer survival in non-metropolitan areas may be due to factors related to access to and time waiting for chemotherapy and/or radiotherapy after breast cancer surgery.
Notes to Editors:
1. Socioeconomic disparities in breast cancer survival: relation to stage at diagnosis, treatment and race
Xue Qin Yu
BMC Cancer (in press)
During embargo, article available here:
After the embargo, article available at journal website:
Please name the journal in any story you write. If you are writing for the web, please link to the article. All articles are available free of charge, according to BioMed Central's open access policy.
Article citation and URL available on request at email@example.com on the day of publication
2. BMC Cancer is an open access journal publishing original peer-reviewed research articles in all aspects of cancer research, including the pathophysiology, prevention, diagnosis and treatment of cancers. The journal welcomes submissions concerning molecular and cellular biology, genetics, epidemiology, and clinical trials. BMC Cancer (ISSN 1471-2407) is indexed/tracked/covered by PubMed, MEDLINE, CAS, Scopus, EMBASE, Current Contents, Thomson Reuters (ISI) and Google Scholar
3. BioMed Central (http://www.