Breast-cancer - Factors Associated With Stage At Diagnosis In Black-and-white Women
american-college; body size; national survey; Oncology; patient characteristics; positive axillary nodes; progesterone-receptor; racial-differences; self-examination; socioeconomic-status; united-states
Background: Numerous studies have reported differences in cancer staging at diagnosis and in survival between Black and White patients with breast cancer. Utilizing data obtained from the National Cancer Institute's (NCI's) Black/White Cancer Survival Study for the period 1985-1986, a new study is presented here that systematically examines multiple explanatory factors (e.g., lack of mammograms) associated with these cancer-staging differences. Purpose: We evaluated within a single study the relationship of selected demographic, lifestyle, antecedent medical experiences, and health care acces s factors to cancer staging at diagnosis in Black and White breast cancer patients. Methods: Data utilized in this population-based cohort study of 1222 eligible women (649 Black and 573 White) newly diagnosed for the period 1985-1986 with histologically confirmed primary breast cancer were obtained from the NCI's Black/White Cancer Survival Study. Sources of data included abstracts of hospital medical records, central review of histology slides by a study consultant pathologist, and patient interviews obtained from three metropolitan areas: Atlanta, New Orleans, and San Francisco-Oakland. Within each area, 70% of all Black incident cases were randomly selected, and a sample of White cases, frequency matched by age groups (20-49 years, 50-64 years, and 65-79 years), was selected for comparison. Stage of breast cancer at diagnosis was classified according to the international tumor-lymph node-metastases (TNM) system. Statistical models utilized in this study included the log-linear and polychotomous logistic regression with multiple predictor variables. Results: Factors associated with cancer staging were differentially expressed in Blacks and Whites. Indicators of access to health care, a lack of mammograms, and an increased body mass index significantly (P<.02) contributed to stage differences in Blacks, whereas income was marginally associated (P = .06) with stage for Whites only. Nuclear grade, having a breast examination by a physician, and a history of patient delay explained approximately 50% of the excess risk for stage III-IV Cancer versus stage I-II(N0) cancer among Blacks compared with Whites (odds ratio- reduction from 2.19 to 1.68). Conclusion: These findings suggest that no single factor or group of factors can explain more than half of the race-stage differences noted in this study with respect to Black and White breast cancer patients.
Hunter C P; Redmond C K; Chen V W; Austin D F; Greenberg R S; Correa P; Muss H B; Forman M R; Wesley M N; Blacklow R S; Kurman R J; Dignam J J; Edwards B K; Shapiro S
Journal of the National Cancer Institute
1993
1993-07
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1093/jnci/85.14.1129" target="_blank" rel="noreferrer noopener">10.1093/jnci/85.14.1129</a>
Race, Incarceration, And Health - A Life-course Approach
course perspective; cumulative disadvantage; employment; Geriatrics & Gerontology; Health; income; life course; marital-status; marriage; mortality; poverty; prison; race; racial-inequality; socioeconomic-status
London A S; Myers N A
Research on Aging
2006
2006-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1177/0164027505285849" target="_blank" rel="noreferrer noopener">10.1177/0164027505285849</a>
Racial-differences In Survival From Breast-cancer - Results Of The National-cancer-institute Black/white Cancer Survival Study
black-white differences; delay; estrogen; experience; General & Internal Medicine; project; race; socioeconomic-status; stage; women
Eley J W; Hill H A; Chen V W; Austin D F; Wesley M N; Muss H B; Greenberg R S; Coates R J; Correa P; Redmond C K; Hunter C P; Herman A A; Kurman R; Blacklow R; Shapiro S; Edwards B K
Jama-Journal of the American Medical Association
1994
1994-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1001/jama.272.12.947" target="_blank" rel="noreferrer noopener">10.1001/jama.272.12.947</a>
Insurance Status And The Variable Management Of Children Presenting To The Emergency Department With Bronchiolitis
asthma; bronchiolitis; care; coverage; Emergency Medicine; health-insurance; hospitalizations; infants; insurance; Pediatrics; respiratory syncytial virus; serious bacterial-infection; socioeconomic-status; united-states; us children
Damore D; Mansbach J M; Clark S; Ramundo M; Camargo C A
Pediatric Emergency Care
2010
2010-10
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1097/PEC.0b013e3181f39861" target="_blank" rel="noreferrer noopener">10.1097/PEC.0b013e3181f39861</a>
Impact of low birth weight on early childhood asthma in the United States
Pediatrics; risk-factors; prevalence; follow-up; severity; infants; responsiveness; socioeconomic-status; bronchial; chronic lung-disease; respiratory morbidity; school-children born
Objective: To estimate the independent contribution of birth weight to asthma prevalence among children younger than 4 years in the United States and to compare the magnitude of its effect on asthma between African American and white children. Design: Cross-sectional analysis using the 1988 National Maternal-infant Health Survey and 1991 Longitudinal Follow-up Survey. Setting: United States. Patients: Eight thousand seventy-one subjects, selected from a randomized, systematic population-based sample and weighted to be nationally representative, who completed both initial and longitudinal follow-up surveys and reported information on asthma diagnosis. Main Outcome Measures: Birth weight and other sociodemographic factors linked to birth outcome were analyzed for independent association with physician-diagnosed asthma by age 3 years. Results: The prevalence of asthma varied by birth weight category: 6.7% in children 2500 g or more at birth, 10.9% in children 1500 to 2499 g at birth, and 21.9% in children less than 1500 g at birth (very low birth weight [VLBW]) (P<.001). Some of the characteristics shown to be independently associated with asthma included: VLBW (odds ratio [OR], 2.9; 95% confidence interval [CI], 2.3-3.6), moderately low birth weight (OR, 1.4, 95% CI, 1.1-1.8), and African American race (OR, 1.9; 95% CI, 1.6-2.4). In stratified analyses, the independent association between VLBW and asthma in white and African American populations was: ORwhite 3.1 (95% CI, 2.24.3) and ORAfrican American, 2.5 (95% CI, 2.0-3.3). The prevalence of VLBW, however, was tripled in African American compared with white children (1.8% vs 0.6%). Conclusions: These data confirm findings of other studies that identify a strong independent association between low birth weight and asthma. For this 1988 national birth cohort, an estimated 4000 excess asthma cases were attributable to birth weight less than 2500 g. Although the strength of the independent association between VLBW and asthma was smaller in the African American population, the substantially increased prevalence of VLBW in this community may contribute to the disproportionately increased prevalence of asthma among African American children.
Brooks A M; Byrd R S; Weitzman M; Auinger P; McBride J T
Archives of Pediatrics & Adolescent Medicine
2001
2001-03
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1001/archpedi.155.3.401" target="_blank" rel="noreferrer noopener">10.1001/archpedi.155.3.401</a>
Factors that influence physical function and emotional well-being among Medicare-Medicaid enrollees
associations; Disparities indicators; Geriatrics & Gerontology; health-status; inequalities; Medicare-Medicaid enrollees; mobility; neighborhood safety; Nursing; older-adults; population; quality-of-life; socioeconomic-status; structural equation models; Subjective; well-being
Dually enrolled Medicare-Medicaid older adults are a vulnerable population. We tested House's Conceptual Framework for Understanding Social Inequalities in Health and Aging in Medicare-Medicaid enrollees by examining the extent to which disparities indicators, which included race, age, gender, neighborhood poverty, education, income, exercise (e.g., walking), and physical activity (e.g., housework) influence physical function and emotional well-being. This secondary analysis included 337 Black (31%) and White (69%) older Medicare-Medicaid enrollees. Using path analysis, we determined that race, neighborhood poverty, education, and income did not influence physical function or emotional wellbeing. However, physical activity (e.g., housework) was associated with an increased self-report of physical function and emotional well-being of beta = .23, p < .001; beta = .17, p < .01, respectively. Future studies of factors that influence physical function and emotional well-being in this population should take into account health status indicators such as allostatic load, comorbidity, and perceived racism/discrimination. (C) 2015 Elsevier Inc. All rights reserved.
Wright K D; Pepper G A; Caserta M; Wong B; Brunker C P; Morris D L; Burant C J; Hazelett S; Kropp D; Allen K R
Geriatric Nursing
2015
2015-03
Journal Article
<a href="http://doi.org/10.1016/j.gerinurse.2015.02.022" target="_blank" rel="noreferrer noopener">10.1016/j.gerinurse.2015.02.022</a>