Poverty, Not Race, Key Factor in Breast Cancer Deaths

Poverty, Not Race, Key Factor in Breast Cancer Deaths

It's long been known that African-American women are more likely to have breast cancer diagnosed at a more advanced stage than white women. However, the question remains whether it is race or socioeconomic status that results in a later diagnosis and, ultimately, higher death rates.

In seeking to answer that question, researchers at Michigan State University analyzed tumor registry data and found that poverty, not race, was key to the late-stage diagnosis and poor survival.

The findings are published in the April 3, 2002, issue of the Journal of the National Cancer Institute.

"This is a poverty issue," said Cathy J. Bradley, associate professor in MSU's Department of Medicine and lead author of the study. "Poor persons, regardless of their race, are likely to have undesirable cancer outcomes."

To reach their conclusion, Bradley and colleagues analyzed statewide cancer data from Medicaid and a Detroit-area registry known as the Metropolitan Detroit Surveillance, Epidemiology and End Results. Nearly 6,000 cases were analyzed over a two-year period.

After adjusting for race and other factors, the researchers determined that low-income women were 41 percent more likely to be diagnosed with late-stage breast cancer and were three times more likely to die than women who were not considered low income.

Race, they concluded, played little or no part in the diagnosis of late-stage breast cancer.

"Race is not statistically significantly associated with breast cancer stage at diagnosis or survival when other covariates are controlled in the analysis," the researchers wrote. "Poverty, as measured by Medicaid status and census data, continues to be a risk factor for unfavorable breast cancer diagnosis, treatment and death."

"This is a serious poverty issue," Bradley said. "If you can focus on making low socioeconomic status less of a burden, you can reduce the breast cancer burden borne by these women."

"Even though race does not directly account for later stage cancer at diagnosis," she said, "the fact remains that a higher proportion of African-American women are of low socioeconomic status, which places them at high risk for being diagnosed with later-stage disease."

Other authors of the paper are Charles W. Given, MSU professor of family practice, and Caralee Roberts of Roberts Research Associates of East Lansing, Mich.

The research was funded by grants from the National Cancer Institute, the Michigan Department of Community Health, Blue Cross Blue Shield of Michigan and the Walther Cancer Center of Indiana.

Contact: Cathy J. Bradley, MSU Department of Medicine(517) 432-3405 or [email protected]

Tom Oswald, University Relations(517) 355-2281

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