The influence of race, ethnicity, and individual socioeconomic factors on breast cancer stage at diagnosis

Document Type

Journal Article

Publication Date



American Journal of Public Health


Volume 96, Issue 12

Inclusive Pages



African Americans--statistics & numerical data; Breast Neoplasms--diagnosis; Breast Neoplasm--ethnology; European Continental Ancestry Group--statistics & numerical data; Hispanic Americans--statistics & numerical data; Risk Assessment; Social Class; Women's Health; Disparities; Race and Ethnicity Data; Cancer


Objectives. Previous research has generally found that racial/ethnicdifferences in breast cancer stage at diagnosis attenuate whenmeasures of socioeconomic status are included in the analysis,although most previous research measured socioeconomic statusat the contextual level. This study investigated the relationbetween race/ethnicity, individual socioeconomic status, andbreast cancer stage at diagnosis.

Methods. Women with stage 0 to III breast cancer were identifiedfrom population-based data from the Surveillance, Epidemiology,and End Results tumor registries in the Detroit and Los Angelesmetropolitan areas. These data were combined with data froma mailed survey in a sample of White, Black, and Hispanic women(n=1700). Logistic regression identified factors associatedwith early-stage diagnosis.

Results. Black and Hispanic women were less likely to be diagnosedwith early-stage breast cancer than were White women (P<.001). After control for study site, age, and individual socioeconomicfactors, the odds of early detection were still significantlyless for Hispanic women (odds ratio [OR]=0.45) and Black women(OR = 0.72) than for White women. After control for the methodof disease detection, the White/Black disparity attenuated toinsignificance; the decreased likelihood of early detectionamong Hispanic women remained significant (OR=0.59).

Conclusion. The way in which racial/ethnic minority status andsocioeconomic characteristics produce disparities in women’sexperiences with breast cancer deserves further research andpolicy attention.


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Peer Reviewed


Open Access