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Assessing the Impact of Socio-economic Variables on Breast Cancer Treatment Outcome Disparity

  • Published : 2013.12.31

Abstract

Background: We studied Surveillance, Epidemiology and End Results (SEER) breast cancer data of Georgia USA to analyze the impact of socio-economic factors on the disparity of breast cancer treatment outcome. Materials and Methods: This study explored socio-economic, staging and treatment factors that were available in the SEER database for breast cancer from Georgia registry diagnosed in 2004-2009. An area under the receiver operating characteristic curve (ROC) was computed for each predictor to measure its discriminatory power. The best biological predictors were selected to be analyzed with socio-economic factors. Survival analysis, Kolmogorov-Smirnov 2-sample tests and Cox proportional hazard modeling were used for univariate and multivariate analyses of time to breast cancer specific survival data. Results: There were 34,671 patients included in this study, 99.3% being females with breast cancer. This study identified race and education attainment of county of residence as predictors of poor outcome. On multivariate analysis, these socio-economic factors remained independently prognostic. Overall, race and education status of the place of residence predicted up to 10% decrease in cause specific survival at 5 years. Conclusions: Socio-economic factors are important determinants of breast cancer outcome and ensuring access to breast cancer treatment may eliminate disparities.

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