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Differences in breast cancer outcomes amongst Black US-born and Caribbean-born immigrants

  • Priscila Barreto-Coelho
  • Danielle Cerbon
  • Matthew Schlumbrecht
  • Carlos M. Parra
  • Judith Hurley
  • Sophia H. L. GeorgeEmail author
Epidemiology
  • 6 Downloads

Abstract

Background

There are few studies that directly investigate disparities in outcome within the African diaspora in the US. We investigated the association between nativity of Black women diagnosed with breast cancer (Caribbean or USA place of birth) and ethnicity, age at diagnosis, treatment, tumor characteristics and outcome.

Methods

The data were obtained from the University of Miami Health System, and Jackson Health System. Individual-level data from 1132 cases was used to estimate hazard rations (HRs) of women born in the Caribbean (Caribbean Blacks, CB) or in the USA (US Black, USB) using Cox proportional hazards regression analysis for overall survival.

Results

The cohort contains data from 624 (54.9%) USB women and 507 (45%) CB women diagnosed with breast cancer between 2006 and 2017. Compared to CB patients, USB patients had more Estrogen Receptor negative (31.4% vs. 39.1%, P = 0.018) and triple negative breast cancers (19.6% vs. 27.9%, P = 0.003). CB women presented at more advanced stages III/IV (44.2% vs. 35.2%; P = 0.016). CB patients showed a better overall survival (hazard ratio, HR = 0.75; 95% CI 0.59–0.96; P = 0.024). Overall Black Hispanic patients had a better overall survival (HR = 0.51; 95% CI 0.28–0.93; P = 0.028) compared to non-Hispanic Black patients.

Conclusion

In conclusion the study found that CB immigrants diagnosed with breast cancer have an improved overall survival when compared with USB patients. This finding suggests that within the African diaspora in the USA, additional factors beyond race contribute to worse outcomes in African Americans.

Keywords

Breast cancer Caribbean-born Black US-born Black Health disparities 

Notes

Author contributions

SHLG had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: SHLG, JH, PB-C. Acquisition, analysis, or interpretation of data: All authors. Drafting of the manuscript: SHLG, PB-C, JH. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: MS, SHLG, DC. Obtained funding: SHLG, JH. Administrative, technical, or material support: SHLG, JH. Supervision: SHLG, JH.

Funding

Research reported in this publication was supported by funds from Sylvester Comprehensive Cancer Center. SG is supported by DOD OCRP W81XWH1810072.

Compliance with ethical standards

Conflict of interest

There are no conflicts of interest.

Research involving human and animal participants

This study did not involve animals.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

This was a retrospective study; informed consent was not sought.

Supplementary material

10549_2019_5403_MOESM1_ESM.docx (898 kb)
Supplementary material 1 (DOCX 897 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Internal MedicineUniversity of Miami/Jackson Memorial HospitalMiamiUSA
  2. 2.Sylvester Comprehensive Cancer CenterMiamiUSA
  3. 3.Division of Gynecology Oncology, Department of Obstetrics and Gynecology, Miller School of MedicineUniversity of MiamiMiamiUSA
  4. 4.Miller School of MedicineUniversity of MiamiMiamiUSA
  5. 5.Division of Medical Oncology, Department of Medicine, Miller School of MedicineUniversity of MiamiMiamiUSA

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