Race still factors in breast cancer survival

Racial disparities in breast cancer survival persist, even after factors such as education, neighborhood and socioeconomic status are accounted for, new research finds.

However, in some cases, those factors did affect the rate of survival, according to the study.

"The worse survival for African-Americans disappeared after adjusting for socioeconomic status and other lifestyle factors," said study author Salma Shariff-Marco, a research scientist at the Cancer Prevention Institute of California, in Fremont.

"There was an effect of neighborhood socioeconomic status associated with survival, with increasing neighborhood socioeconomic status associated with better survival," she said.

Shariff-Marco was scheduled to present the findings Tuesday at the annual cancer prevention conference of the American Association for Cancer Research, in San Diego.

Previous breast cancer research has consistently shown the worst survival rates for black women, and white women have the next highest mortality rates. Hispanics and Asians typically have the lowest mortality rates.

Experts have debated what factors might be responsible for these differences, but two factors that are always suspect are socioeconomic status and education.

To see if racial differences would remain after adjusting for these factors, Shariff-Marco and her colleagues reviewed data on 4,405 women diagnosed with breast cancer between 1995 and 2008.

There were 1,068 whites, 1,670 Hispanics, 993 blacks and 674 Asian-Americans in the study. The women were all from the San Francisco Bay Area.

When they looked at the unadjusted data, researchers found that survival rates were the worst for blacks, and the best for Hispanics and Asians compared with whites.

But, when they adjusted for treatment and other lifestyle factors, blacks had an improved survival rate, similar to that of white women. When the researchers applied these same adjustment factors to Hispanic and Asian women, their survival remained above that of black and white women.

The researchers also found that neighborhood socioeconomic status seemed to play a role. Compared with whites with more education and a high neighborhood socioeconomic status, blacks had worse survival, regardless of their own education level, if they lived in a poorer neighborhood.

Hispanics living in wealthier neighborhoods, regardless of their own education level, had better survival than well-educated whites living in wealthier areas. The same was true for Asian women, except that their education level seemed to matter in their improved survival.

Shariff-Marco said it's not clear why the neighborhood characteristics seem to be so important, often even more important than a person's own education.