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Demographic and geographic variations in Breast Cancer mortality among US Hispanics

Demographic and geographic variations in Breast Cancer mortality among US Hispanics. Maria C. Mejia de Grubb, MD, MPH ; Barbara Kilbourne, PhD; Courtney Kihlberg, MD, MSPH; and Robert Levine, MD. Department of Family and Community Medicine Meharry Medical College Nashville, TN

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Demographic and geographic variations in Breast Cancer mortality among US Hispanics

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  1. Demographic and geographic variations in Breast Cancer mortality among US Hispanics Maria C. Mejia de Grubb, MD, MPH; Barbara Kilbourne, PhD; Courtney Kihlberg, MD, MSPH; and Robert Levine, MD. Department of Family and Community Medicine Meharry Medical College Nashville, TN October 30, 2012

  2. Presenter Disclosures The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: “No relationships to disclose”

  3. Background Breast cancer is the leading cause of cancer death among Hispanic women. Hispanic women have a 20 % greater risk of dying from breast cancer than non-Hispanic whites once a diagnosis is made even though incidence and mortality are lower. Several factors might contribute to variations of breast cancer mortality by place.

  4. Objective Describe demographic and geographic variations in Hispanic mortality from malignant neoplasm of the breast among US women ages 35-64 and 65-85+ years.

  5. Methods Age-adjusted (Year 2000 standard) mortality rates and 95% confidence intervals were obtained from the Compressed Mortality File as presented on the public US Centers for Disease Control and Prevention WONDER (Wide-ranging Online Data for Epidemiologic Research) internet website. ICD-10 code C50 (Malignant neoplasm of the breast) All analyses were performed using SAS, v9.23 OLS regression models with dependent variable= age adjusted mortality rates (35-64 and 65-85+ years), and independent variables % Hispanics ≥25 years = annual income below poverty, not high school graduates, and renters.

  6. Results

  7. Table 1. Hispanic and Non-Hispanic, Age-adjusted Female Breast Cancer Mortality According to Race (Ages 35-85+ years). 1999-2009. USA

  8. Table 2. Hispanic and Non-Hispanic, Age-adjusted Female Breast Cancer Mortality According to Race and Age. 1999-2009. USA

  9. Table 3. Hispanic and Non-Hispanic, Age-adjusted Female Breast Cancer Mortality (Age 35-64 years) According to Race and Census Region. 1999-2009. USA

  10. Table 4. Hispanic and Non-Hispanic, Age-adjusted Female Breast Cancer Mortality (Age 65-85+ years) According to Race and Census Region. 1999-2009. USA

  11. Fig.1. Breast Cancer Mortality (Ages 35-64 Years) among Hispanic White Females According to State and Percent Hispanic Population. 1999-2009. USA. Age –Adjusted Breast Cancer Deaths for 100,000 Population Percent Hispanic Population

  12. Fig.2. Breast Cancer Mortality (Ages 65-85+) among Hispanic White Females According to State and Percent Hispanic Population. 1999-2009. USA Age –Adjusted Breast Cancer Deaths for 100,000 Population Percent Hispanic Population

  13. Table 5. Ordinary Least Squares Regression (OLS) predicting Hispanic White Breast Cancer Mortality in 106 US counties. 1999-2009 Poverty %= percentage of Hispanics living in poverty, Education %= percentage of Hispanics with less than a high school education Renters %= percentage of Hispanics that are renters.

  14. Table 6. Correlations Between Breast Cancer Mortality Rates And Percentage Of Population Residing In Places Along The Urban To Rural Continuum By State

  15. Strengths and Limitations Strengths: Mortality data has been validated for breast cancer and Hispanic ethnic classifications on death certificates. The use of state level data allows to detect patterns of geographical variations. Limitations: Social and structural factors are suitable for hypothesis generation but not for hypothesis testing. Small power for detection of ethnic variations within Hispanic population.

  16. Conclusions The data showed significant geographic and racial variations among Hispanic populations. Analytic epidemiologic studies are needed to ascertain the underlying reasons, with special reference to particularly strong protective effects among AI/AN and AA Hispanics relative to non-Hispanic AI/AN and AA groups. The observation of relatively high rates among elderly API residents in the western region needs further exploration. Consideration of these factors would contribute to public health planning efforts.

  17. Acknowledgements This research was supported grant number 5 P20 MD 000516 from the National Institute of Minority Health and Health Disparities. Contact: mmejiadegrubb@mmc.edu

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