International Journal of Epidemiology, Vol 26, 1151-1158, Copyright © 1997 by International Epidemiological Association
L Meng, G Maskarinec and L Wilkens
BACKGROUND: Previous studies have described differences in breast cancer
survival among women from various ethnic backgrounds even after adjustment
for stage at diagnosis. The aim of this study is to identify factors that
could explain this disparity in prognosis and to update breast cancer
survival patterns in Hawaii. METHODS: The Hawaii Tumor Registry identified
3345 breast cancer cases diagnosed between 1980 and 1988. The following
covariates were studied: ethnicity, stage at diagnosis, geographical
residence, and menopausal, marital and socioeconomic statuses. The
Kaplan-Meier method and proportional hazards regression were used to
estimate survival by group. RESULTS: Native Hawaiian and Filipino women had
a higher risk of dying within 5 years than women of other ethnic groups.
Japanese had the highest survival probability, followed by Chinese and
Caucasians. Stage was the most important prognostic factor. Married women
had better survival than widowed and divorced women. Filipinos had a much
greater chance of dying from localized cancer than other women with
localized disease. Geographical residence, menopausal and socioeconomic
statuses were not associated with survival. CONCLUSIONS: Despite an overall
improvement in breast cancer survival, ethnic disparity in prognosis still
exists. Other possible explanations for the differential prognosis, such as
treatment, diet, genetics, obesity, oestrogen receptor and hormonal
statuses need to be explored in future studies.
ARTICLES
Ethnic differences and factors related to breast cancer survival in Hawaii
Prevention and Control Program, Cancer Research Center of Hawaii, University of Hawaii, Honolulu 96813, USA.
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