Increasing Black:White disparities in breast cancer mortality in the 50 largest cities in the United States

• Published in: Cancer epidemiology Vol. 38; no. 2; pp. 118 - 123
• Main Authors: Hunt, Bijou R, Whitman, Steve, Hurlbert, Marc S
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01-04-2014; Elsevier; Elsevier Limited
• Subjects: Age; Analysis. Health state; Big cities; Biological and medical sciences; Black or African American; Black People - statistics & numerical data; Breast cancer; Breast Neoplasms - ethnology; Breast Neoplasms - mortality; Cancer; Census of Population; Cities; Cities - epidemiology; Confidence intervals; Epidemiology; Female; General aspects; Health Status Disparities; Hematology, Oncology and Palliative Medicine; Humans; Internal Medicine; Mammography; Medical sciences; Mortality; Public health. Hygiene; Public health. Hygiene-occupational medicine; Racial disparities; Ratios; Tumors; United States - epidemiology; White People - statistics & numerical data; United States; North America; America; Cities; New York; United States > US; USA; Racial disparities; Breast cancer; Big cities; Human; Breast disease; Urban environment; Mortality; Negroid; Malignant tumor; Epidemiology; Mammary gland diseases; Race; Disparity; Caucasoid; Cancer
• ISSN: 1877-7821; 1877-783X; 1877-783X
• DOI: 10.1016/j.canep.2013.09.009

Abstract Introduction : This paper presents race-specific breast cancer mortality rates and the corresponding rate ratios for the 50 largest U.S. cities for each of the 5-year intervals between 1990 and 2009. Methods : The 50 largest cities in the U.S. were the units of analysis. Numerator data were abstracted from national death files where the cause was malignant neoplasm of the breast (ICD-9 = 174 and ICD-10 = C50) for women. Population-based denominators were obtained from the U.S. Census Bureau for 1990, 2000, and 2010. To measure the racial disparity, we calculated non-Hispanic Black:non-Hispanic White rate ratios (RRs) and confidence intervals for each 5-year period. Results : At the final time point (2005–2009), two RRs were less than 1, but neither significantly so, while 39 RRs were >1, 23 of them significantly so. Of the 41 cities included in the analysis, 35 saw an increase in the Black:White RR between 1990–1994 and 2005–2009. In many of the cities, the increase in the disparity occurred because White rates improved substantially over the 20-year study period, while Black rates did not. There were 1710 excess Black deaths annually due to this disparity in breast cancer mortality, for an average of about 5 each day. Conclusion : This analysis revealed large and growing disparities in Black:White breast cancer mortality in the U.S. and many of its largest cities during the period 1990–2009. Much work remains to achieve equality in breast cancer mortality outcomes.