Association of Race with Late-Stage Breast Cancer Diagnosis in Miami-Dade County
Abstract
Introduction and Objective. The early detection of breast cancer is crucial for decreasing the likelihood of mortality, as treatment options are more effective in early-stage breast cancers. The rates of late-stage breast cancer in Miami-Dade County (MDC) are a significant burden when compared to the rates in Florida as a whole. Approximately 64% of all breast cancers in Florida are diagnosed in the early stages, while this number is only 59% in MDC. Furthermore, while the incidence of breast cancer in MDC is highest in White women, mortality is highest in Black women. This suggests that Black women in MDC may experience disparities in breast cancer diagnosis that lead to higher mortality in this population. In this study, we aim to study whether Black women in MDC have higher rates of late-stage breast cancer diagnosis, when compared to their White counterparts. Methods. A comparative cross-sectional study of 21,605 women was performed using data from the Florida Cancer Data System (FCDS). Exploratory analysis was performed to initially profile the study population. Bivariate analysis was utilized to examine the association between race and late-stage breast cancer diagnosis, as well as between race and demographic characteristics, such as poverty level, insurance status, ethnicity, and marital status. Multiple logistic regression analysis was utilized before and after adjusting for age, ethnicity, insurance status, poverty level and marital status to determine the unadjusted and adjusted association (odds ratio, 95% CI) between race and stage at diagnosis. Results. The majority of the sample were White women (83.6%), with a smaller percentage being Black women (16.4%). Most women were diagnosed with early-stage breast cancer (68.1%), while a significant proportion had late-stage diagnoses (31.9%), with a higher prevalence of late-stage cases among Black women compared to White women. Black women in the study tended to be younger, less frequently Hispanic, and faced higher rates of Medicaid or no health insurance, greater poverty levels, and single marital status. Despite adjusting for age, insurance status, poverty, and marital status, the odds of Black women being diagnosed with late-stage breast cancer remained higher (95% CI, OR 1.4 [1.3-1.5]). Conclusions-Implications. This study finds that Black women with breast cancer are more likely to be diagnosed at later stages and younger age when compared to their White counterparts. These findings underscore the importance of equitable breast cancer screening guidelines, especially for Black women. This study calls for further research into the complex factors contributing to later-stage diagnosis and subsequently higher mortality rates in Black women with breast cancer.
Keywords
Breast cancer; racial disparities, Miami-Dade County; Florida; late-stage diagnosis
Presentation Type
Poster Presentation
Association of Race with Late-Stage Breast Cancer Diagnosis in Miami-Dade County
Introduction and Objective. The early detection of breast cancer is crucial for decreasing the likelihood of mortality, as treatment options are more effective in early-stage breast cancers. The rates of late-stage breast cancer in Miami-Dade County (MDC) are a significant burden when compared to the rates in Florida as a whole. Approximately 64% of all breast cancers in Florida are diagnosed in the early stages, while this number is only 59% in MDC. Furthermore, while the incidence of breast cancer in MDC is highest in White women, mortality is highest in Black women. This suggests that Black women in MDC may experience disparities in breast cancer diagnosis that lead to higher mortality in this population. In this study, we aim to study whether Black women in MDC have higher rates of late-stage breast cancer diagnosis, when compared to their White counterparts. Methods. A comparative cross-sectional study of 21,605 women was performed using data from the Florida Cancer Data System (FCDS). Exploratory analysis was performed to initially profile the study population. Bivariate analysis was utilized to examine the association between race and late-stage breast cancer diagnosis, as well as between race and demographic characteristics, such as poverty level, insurance status, ethnicity, and marital status. Multiple logistic regression analysis was utilized before and after adjusting for age, ethnicity, insurance status, poverty level and marital status to determine the unadjusted and adjusted association (odds ratio, 95% CI) between race and stage at diagnosis. Results. The majority of the sample were White women (83.6%), with a smaller percentage being Black women (16.4%). Most women were diagnosed with early-stage breast cancer (68.1%), while a significant proportion had late-stage diagnoses (31.9%), with a higher prevalence of late-stage cases among Black women compared to White women. Black women in the study tended to be younger, less frequently Hispanic, and faced higher rates of Medicaid or no health insurance, greater poverty levels, and single marital status. Despite adjusting for age, insurance status, poverty, and marital status, the odds of Black women being diagnosed with late-stage breast cancer remained higher (95% CI, OR 1.4 [1.3-1.5]). Conclusions-Implications. This study finds that Black women with breast cancer are more likely to be diagnosed at later stages and younger age when compared to their White counterparts. These findings underscore the importance of equitable breast cancer screening guidelines, especially for Black women. This study calls for further research into the complex factors contributing to later-stage diagnosis and subsequently higher mortality rates in Black women with breast cancer.