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Comparative Study
. 2010 Jul 5:9:35.
doi: 10.1186/1476-072X-9-35.

Identification of racial disparities in breast cancer mortality: does scale matter?

Nancy Tian  1 , Pierre Goovaerts, F Benjamin Zhan, Jeff G Wilson
Affiliations
Comparative Study

Identification of racial disparities in breast cancer mortality: does scale matter?

Nancy Tian et al. Int J Health Geogr. .

Abstract

Background: This paper investigates the impact of geographic scale (census tract, zip code, and county) on the detection of disparities in breast cancer mortality among three ethnic groups in Texas (period 1995-2005). Racial disparities were quantified using both relative (RR) and absolute (RD) statistics that account for the population size and correct for unreliable rates typically observed for minority groups and smaller geographic units. Results were then correlated with socio-economic status measured by the percentage of habitants living below the poverty level.

Results: African-American and Hispanic women generally experience higher mortality than White non-Hispanics, and these differences are especially significant in the southeast metropolitan areas and southwest border of Texas. The proportion and location of significant racial disparities however changed depending on the type of statistic (RR versus RD) and the geographic level. The largest proportion of significant results was observed for the RD statistic and census tract data. Geographic regions with significant racial disparities for African-Americans and Hispanics frequently had a poverty rate above 10.00%.

Conclusions: This study investigates both relative and absolute racial disparities in breast cancer mortality between White non-Hispanic and African-American/Hispanic women at the census tract, zip code and county levels. Analysis at the census tract level generally led to a larger proportion of geographical units experiencing significantly higher mortality rates for minority groups, although results varied depending on the use of the relative versus absolute statistics. Additional research is needed before general conclusions can be formulated regarding the choice of optimal geographic regions for the detection of racial disparities.

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Figures

Figure 1
Figure 1
Age-specific mortality rate (a) and percentage of mortality cases (b) for breast cancer by race in Texas, 1995-2005.
Figure 2
Figure 2
African-American breast cancer mortality: significant racial disparities according to the RD statistic at the census tract (a,b), zip code (c), and county levels (d). Map b shows a magnified portion of map a (rectangle).
Figure 3
Figure 3
Significant racial disparities for breast cancer according to the RR statistic. Map a shows results for African-American at the zip code level, with a magnified portion in map b. Maps c and d display the significant disparities for African-Americans and Hispanics at the county level.
Figure 4
Figure 4
Maps of rate difference and rate ratio between African-American (a,b) or Hispanic women (c,d) and White non-Hispanic women.
Figure 5
Figure 5
Hispanic breast cancer mortality: significant racial disparities according to the RD statistic at the census tract (a,b), zip code (c), and county levels (d). Map b shows a magnified portion of map a (rectangle).
See this image and copyright information in PMC

References

    1. Greenlee RT, Hill-Harmon MB, Murray T. Cancer statistics, 2001. CA: A Cancer Journal for Clinicians. 2001;51(1):15–36. doi: 10.3322/canjclin.51.1.15. - DOI - PubMed
    1. Feuer EJ, Wun LM, Boring CC, Flanders WD, Timmel MJ, Tong T. The lifetime risk of developing breast cancer. Journal of the National Cancer Institute. 1993;85(11):892–897. doi: 10.1093/jnci/85.11.892. - DOI - PubMed
    1. Lannin DR, Mathews HF, Mitchell J, Swanson MS, Swanson FH, Edwards MS. Influence of socioeconomic and cultural factors on racial differences in late-stage presentation of breast cancer. Journal of American Medical Association. 1998;279(22):1801–1807. doi: 10.1001/jama.279.22.1801. - DOI - PubMed
    1. Goovaerts P. Visualizing and testing the impact on late-stage breast cancer incidence: a non-parametric geostatistical approach. International Journal of Health and Place. 2010;16:321–330. doi: 10.1016/j.healthplace.2009.10.017. - DOI - PMC - PubMed
    1. Tian N, Wilson J, Zhan FB. Female breast cancer mortality clusters within racial groups in the United States. International Journal of Health & Place. 2010;16(2):209–218. - PubMed

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