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Does having insurance affect differences in clinical presentation between Hispanic and non-Hispanic white women with breast cancer?

  1. A. Tyler Watlington MD, MSPH1,
  2. Tim Byers MD, MPH1,†,*,
  3. Judy Mouchawar MD, MSPH2,
  4. Angela Sauaia MD, PhD1,3,
  5. Jenn Ellis MSPH2

Article first published online: 9 APR 2007

DOI: 10.1002/cncr.22640

Issue

Cancer

Cancer

Volume 109, Issue 10, pages 2093–2099, 15 May 2007

Additional Information

How to Cite

Watlington, A. T., Byers, T., Mouchawar, J., Sauaia, A. and Ellis, J. (2007), Does having insurance affect differences in clinical presentation between Hispanic and non-Hispanic white women with breast cancer?. Cancer, 109: 2093–2099. doi: 10.1002/cncr.22640

Author Information

  1. 1

    Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado

  2. 2

    Clinical Research Unit, Kaiser Permanente Colorado, Denver, Colorado

  3. 3

    Division of Health Care Policy and Research, Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado

  1. †

    Fax: (303) 724-0964

*Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Mail Stop F-519, 13001 East 17th Pl., Aurora, CO, 80045

  1. †

    Fax: (303) 724-0964

Publication History

  1. Issue published online: 25 APR 2007
  2. Article first published online: 9 APR 2007
  3. Manuscript Accepted: 19 JAN 2007
  4. Manuscript Revised: 20 DEC 2006
  5. Manuscript Received: 30 AUG 2006

Funded by

  • American Cancer Society Physician Training Award in Preventive Medicine. Grant Number: PTAM 312-939-2276

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Keywords:

  • breast cancer;
  • Hispanic;
  • clinical presentation;
  • tumor characteristics;
  • equal access;
  • insurance;
  • biology

Abstract

BACKGROUND

Hispanic women with breast cancer present differently than do non-Hispanic white (NHW) women. Lack of access to care has been offered as an explanation for these differences. In this study breast cancer presentation was examined in Hispanic women in a comprehensive, equal-access health care system.

METHODS

Hispanic and NHW breast cancer cases registered between 1995 and 2004 in the Kaiser Permanente of Colorado Tumor Registry were compared by age at diagnosis, stage, tumor grade, size, and receptor status. Multivariate logistic regression was performed to generate age-adjusted odds ratios by ethnicity and each tumor characteristic.

RESULTS

A total of 139 Hispanic women and 2118 NHW women with breast cancer were identified. Hispanic women had a mean average age at diagnosis of 56 years compared with 61 years for NHW women (P < .0001). Use of mammographic screening services in the prior 2 years was similar by ethnicity. Relative to NHW women, Hispanic women had age-adjusted odds ratios of 2.70 (95% confidence interval [CI]: 1.26–5.77) for having stage IV disease, 2.25 (95% CI: 1.39–3.67) for having poorly differentiated tumors, 2.16 (95% CI: 1.26–3.69) for having a tumor greater than 5 cm, and 1.88 (95% CI: 1.24–2.81) for having estrogen receptor-negative tumors.

CONCLUSIONS

Despite equal access to health care services, differences persist in the size, stage, and grade of breast cancer for Hispanic women compared with NHW women. The results of the study suggest a biologic/genetic basis for these differences. Cancer 2007. © 2007 American Cancer Society.

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