Abstract
Breast cancer is the most common malignancy in women in the United States but significant disparities exist for African American women compared to Caucasian women. African American women present with breast cancer at a younger age and with a greater incidence under the age of 50 years, develop histologically more aggressive tumors that are at a more advanced stage at presentation, and have a worse disease-free and overall survival than Caucasian women. The biological characteristics of the primary tumor play an important role in determining the outcome of the disparity, and significant differences have been identified between African American and Caucasian breast cancer in steroid receptor and growth factor receptor content, mutations in cell cycle components, chromosomal abnormalities, and tumor suppressor and other cancer genes. The consequences of the biological factors are influenced by a variety of nonbiological factors, including socioeconomic, health care access, reproductive, and confounding factors. The nonbiological factors may act directly to enhance (or inhibit) the consequences of the biological changes, indirectly to facilitate outcome of the disparity, or as a cofounding factor, driving the association between the biological factors and the disparity. The prevention and management of the disparities will require an understanding of the relationship of biological and nonbiological factors. The present review was undertaken to promote this understanding by describing the biological basis of the four major disparities - early age of onset, more advanced stage of disease, more aggressive histologic changes, and worse survival - and the important relationship to the nonbiological factors. A model is proposed to provide a comprehensive view of this relationship, with the goal of facilitating an understanding of each disparity and the issues that need to be addressed to eliminate the disparity.
Keywords
Breast cancerMedicineSurgical oncologyDiseaseCancerConfoundingOncologySocioeconomic statusDemographyInternal medicinePopulationEnvironmental health
Affiliated Institutions
Related Publications
Trends in Breast Cancer by Race and Ethnicity
In this article, the American Cancer Society (ACS) describes trends in incidence, mortality, and survival rates of female breast cancer in the United States by race and ethnicit...
Reduced mortality associated with body mass index (BMI) in African Americans relative to Caucasians.
Although obesity is especially common in African-American women, the relationship between body mass index (BMI, kg/m2) and mortality primarily has been studied in Caucasians, an...
Epidemiology of Prostate Cancer
Prostate cancer is the second most frequent cancer diagnosis made in men and the fifth leading cause of death worldwide. Prostate cancer may be asymptomatic at the early stage a...
Ethnic differences in peripheral arterial disease in the NHLBI Genetic Epidemiology Network of Arteriopathy (GENOA) study
Few studies have investigated whether ethnic groups differ in the prevalence of peripheral arterial disease (PAD). We compared the distribution of the ankle-brachial index (ABI)...
Cancer Disparities by Race/Ethnicity and Socioeconomic Status
This article highlights disparities in cancer incidence, mortality, and survival in relation to race/ethnicity, and census data on poverty in the county or census tract of resid...
Publication Info
- Year
- 2013
- Type
- review
- Volume
- 15
- Issue
- 3
- Pages
- 208-208
- Citations
- 130
- Access
- Closed
External Links
Social Impact
Altmetric
PlumX Metrics
Social media, news, blog, policy document mentions
Citation Metrics
130
OpenAlex
Cite This
David N. Danforth
(2013).
Disparities in breast cancer outcomes between Caucasian and African American women: a model for describing the relationship of biological and nonbiological factors.
Breast Cancer Research
, 15
(3)
, 208-208.
https://doi.org/10.1186/bcr3429
Identifiers
- DOI
- 10.1186/bcr3429