Are There Differences in Treatment and Survival Between Poor, Older Black and White Women with Breast Cancer?

Abstract

Objectives: To explore differences in treatment and survival outcome between poor, older black and white women with breast cancer.

Design: Retrospective cohort study.

Setting: Public safety net hospital.

Participants: Women aged 65 and older diagnosed with breast cancer from 1999 to 2008 (n = 1,000).

Measurements: Breast cancer treatments that black and white women sought were compared using the Pearson chi-square test. All-cause mortality of black and white women was compared using hazard ratios derived from a multivariate Cox proportional hazards model.

Results: There was no significant difference between older black and white women in surgical treatment, radiation therapy, chemotherapy, or hormone therapy over the study period. Race was not a significant predictor of survival in the Cox proportional hazards model that controlled for stage of cancer, age at diagnosis, dual-eligibility status, comorbid conditions, body mass index, smoking history, mammogram screening, and treatment for breast cancer.

Conclusion: Race did not appear to affect treatment or mortality in a cohort of older women with low socioeconomic status. This may be associated with similar healthcare delivery and equivalent access to health care for the older black and white women in this study.

Keywords: black; breast cancer; elderly; survival; white.