Outcome Disparities in African American Compared with European American Women with ER +HER 2- Tumors Treated within an Equal-Access Health Care System
| Autor: | Benjamin Freeman, Nicholas S. Costantino, Rachel E. Ellsworth, Craig D. Shriver |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
0301 basic medicine Oncology medicine.medical_specialty Receptor ErbB-2 Epidemiology Breast cancer mortality Breast Neoplasms Health Services Accessibility White People 03 medical and health sciences 0302 clinical medicine Breast cancer Internal medicine Health care Tumor stage medicine Humans Healthcare Disparities Pathological Allele frequency Survival analysis Aged Gynecology African american business.industry Original Report: Public Health General Medicine Middle Aged medicine.disease Survival Analysis United States Black or African American 030104 developmental biology Receptors Estrogen Socioeconomic Factors 030220 oncology & carcinogenesis Female Transcriptome business |
| Zdroj: | Ethnicity & Disease. 26:407 |
| ISSN: | 1945-0826 1049-510X |
| DOI: | 10.18865/ed.26.3.407 |
| Popis: | Purpose: Breast cancer mortality rates are higher for African American women (AAW) than for any other ethnic group in the United States. Recent reports suggest that outcome disparities between AAW and European American women (EAW) are present in the ER+HER2- subtype. To improve our understanding, pathological characteristics, mortality and molecular profiles from women treated within an equal-access health care system were evaluated. Procedures: All AAW (n=90) and EAW (n=308) with ER+HER2- tumors were identified. Gene expression profiles were generated from primary breast tumors from 57 AAW and 181 EAW. Pathological characteristics, survival and gene expression analysis were evaluated using chi-square analysis, log-rank tests and ANOVA. Results: Tumors from AAW were significantly more likely to be PR-, Ki67+ and of higher grade. Tumor stage, size and lymph node status did not differ significantly, nor did mortality rates (P=.879). At the molecular level, genes PSPHL and CRYBB2P1 were expressed at significantly higher levels in tumor tissues as well as normal stroma and blood from AAW. Polymorphisms controlling expression of each gene were identified with minor allele frequencies differing significantly between populations but not between cases and controls within each population. Conclusions: Survival disparities were not detected in patients with ER+HER2- tumors treated within an equal-access health care system and molecular differences in tumors were not causal. Thus, outcome disparities in AAW with ER+HER2- tumors are largely attributable to socioeconomic factors affecting access to screening and treatment, rather than reflecting underlying biological differences. Ethn Dis. 2016;26(3):407-416; doi:10.18865/ed.26.3.407 |
| Databáze: | OpenAIRE |
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