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. 2021 Feb;8(1):147-156.
doi: 10.1007/s40615-020-00766-y. Epub 2020 May 8.

Social Determinants of Racial Disparities in Breast Cancer Mortality Among Black and White Women

Oluwole Adeyemi Babatunde  1   2   3 , Jan M Eberth  4   5 , Tisha Felder  4   6 , Robert Moran  5 , Samantha Truman  5 , James R Hebert  4   5   6   7 , Jiajia Zhang  5 , Swann Arp Adams  4   5   6
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Social Determinants of Racial Disparities in Breast Cancer Mortality Among Black and White Women

Oluwole Adeyemi Babatunde et al. J Racial Ethn Health Disparities. 2021 Feb.

Abstract

Introduction: Mortality from breast cancer among Black women is 60% greater than that of White women in South Carolina (SC). The aim of this study was to assess racial differences in mortality among Black and White breast cancer patients based on variations in social determinants and access to state-based early detection programs.

Methods: We obtained a retrospective record for breast cancer patients diagnosed between 2002 and 2010 from the SC Central Cancer Registry. Mortality was the main outcome while race-stratified Cox proportional hazard models were performed to assess disparities in mortality. We assessed effect modification, and we used an automated backward elimination process to obtain the best fitting models.

Results: There were 3286 patients of which the majority were White women (2186, 66.52%). Compared with married White women, the adjusted hazard ratio (aHR) for mortality was greatest among Black unmarried women (aHR 2.31, CI 1.83, 2.91). Compared with White women who lived in the Low Country region mortality was greatest among Black women who lived in the Midland (aHR 2.17 CI 1.47, 3.21) and Upstate (aHR 2.96 CI 1.96, 2.49). Mortality was higher among Black women that were not receiving services in the Best Chance Network (BCN) program (aHR 1.70, CI 1.40, 2.04) compared with White women.

Conclusions: To reduce the racial disparity gap in survival in SC, Black breast cancer patients who live in the Upstate, are unmarried, and those that are not enrolled in the BCN program may benefit from more intense navigation efforts directed at early detection and linkage to breast cancer treatments.

Keywords: Adjuvant hormone treatment; Breast cancer; Health region; Marital status; Racial disparity; South Carolina; Survival.

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Conflict of interest statement

Conflicts.

No Author declares a conflict of interest

Figures

Figure 1:
Figure 1:
Kaplan Meier curve for the association between race and 12-year breast cancer specific mortality in South Carolina (p<0.01)
See this image and copyright information in PMC

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