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Color or money?: The impact of socioeconomic status and race/ethnicity on breast cancer mortality

      Highlights

      • Mortality is worst in Black females regardless of socioeconomic or insurance status.
      • Only in the richest quartile did Blacks have survival like Whites in the poorest.
      • Outcome disparities improved with higher socioeconomic status.

      Abstract

      Background

      Although the incidence of breast cancer is highest in White women, Black women die at a higher rate. Our aim was to compare the relative association between race/ethnicity and socioeconomic status on breast cancer mortality.

      Methods

      We identified female breast cancer patients diagnosed between 2007 - 2011 and followed through 2016 in the SEER database. Patients were grouped into socioeconomic quartiles by a prosperity index. The primary outcome of interest was 5-year cancer-specific survival.

      Results

      A total of 286,520 patients were included. Five-year survival was worst for Black women compared to other races/ethnicities in each socioeconomic quartile. When compared to White women in the lowest quartile, Black women in the lowest quartile, 2nd quartile, and 3rd quartile experienced the lowest 5-year survival rates (Hazard ratio 1.33, 1.23, 1.20; P < 0.01).

      Conclusion

      Regarding cancer mortality, only in the most prosperous quartile do Black women achieve a similar outcome to the poorest quartile White women.

      Keywords

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