Breast cancer characteristics at diagnosis and survival among Arab–American women compared to European– and African–American women
- 163 Downloads
Background Data from Arab world studies suggest that Arab women may experience a more aggressive breast cancer phenotype. To investigate this finding, we focused on one of the largest settlements of Arabs and Iraqi Christians (Chaldeans) in the US, metropolitan Detroit- a SEER reporting site since 1973. Materials and methods We identified a cohort of primary breast cancer cases diagnosed 1973–2003. Using a validated name algorithm, women were identified as being of Arab/Chaldean descent if they had an Arab last or maiden name. We compared characteristics at diagnosis (age, grade, histology, SEER stage, and marker status) and overall survival between Arab–, European–, and African–Americans. Results The cohort included 1,652 (2%) women of Arab descent, 13,855 (18%) African–American women, and 63,615 (80%) European–American women. There were statistically significant differences between the racial groups for all characteristics at diagnosis. Survival analyses overall and for each SEER stage showed that Arab–American women had the best survival, followed by European–American women. African–American women had the poorest overall survival and were 1.37 (95% confidence interval: 1.23–1.52) times more likely to be diagnosed with an aggressive tumor (adjusting for age, grade, marker status, and year of diagnosis). Conclusion Overall, Arab–American women have a distribution of breast cancer histology similar to European–American women. In contrast, the stage, age, and hormone receptor status at diagnosis among Arab–Americans was more similar to African–American women. However, Arab–American women have a better overall survival than even European–American women.
KeywordsArab Breast cancer Epidemiology Incidence Survival
This work was supported by a Department of Defense Breast Cancer Research Program Predoctoral Fellowship (W81XWH-04-1-0395 to SHA), by grants from the Breast Cancer Foundation (SDM) and the Burroughs Wellcome Fund (SDM), and the National Institutes of Health through the University of Michigan’s Cancer Center Support (5 P30 CA46592 to SBG and SDM). The funding sources were not involved in the study design or data collection, analyses, or interpretation. The authors had full responsibility of the writing of the manuscript and the decision to submit for publication.
- 4.Chiedozi LC, El-hag IA, Kollur SM (2003) Breast diseases in the northern region of Saudi Arabia. Saudi Med J 6:623–627Google Scholar
- 9.El Saghir NS, Shamseddine AI, Geara F, Bikhazi K, Rahal B, Salem ZMK, Taher A, Tawil A, El Khatib Z, Abbas J, Hourani M, Seoud M (2002) Age distribution of breast cancer in Lebanon: increased percentages and age adjusted incidence rates of younger-aged groups at presentation. J Med Liban 50:3–9PubMedGoogle Scholar
- 10.El Saghir NS, Adib S, Mufarru A, Kahwaji S, Taher A, Issa P, Shamseddine AI (1998) Cancer in Lebanon: analysis of 10220 cases from the American University of Beirut medical center. Leb Med J 46:4–11Google Scholar
- 13.Freedman LS, Edwards BK, Ries LAG, Young JL (eds) (2006) Cancer incidence in four member countries (Cyprus, Egypt, Israel, and Jordan) of the Middle East cancer consortium (MECC) compared with US SEER. National Cancer Institute. NIH Pub. No. 06–5873. Bethesday, MDGoogle Scholar
- 14.Wayne State University College of Urban, Labor, and Metropolitan Affairs (2000) Census: ethnic profile of Arab and Chaldean populations in metropolitan DetroitGoogle Scholar
- 15.Schwarts KL, Kulwicki A, Weiss LK, Fakhouri H, Sakr W, Kau G, Severson RK (2004) Cancer among Arab Americans in the metropolitan Detroit area. Ethn Dis 14:141–146Google Scholar
- 16.Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas DB (eds) Cancer incidence in five continents Vol. VIII. International Agency for Research in Cancer. IARC Scientific Publication No. 155. Lyon, FranceGoogle Scholar
- 22.UN News Service (2007) UN officials lauds US decision to shelter 7,000 of the most vulnerable Iraqi refugees. http://www.un.org/apps/news/printnewsAr.asp?nid=21585. 15 Feb 2007
- 23.Karoub J (2008) ABC News. Detroit expects half of Iraqi refugees. http://abcnews.go.com/print?id=3233636