Socioeconomic factors and breast carcinoma in multicultural women

Breast carcinoma is the most common cancer in women in the U.S. and the sec ond Leading cause of cancer death in women Furthermore, there are racial di fferences in breast carcinoma incidence, mortality, and survival rates. Soc ial and economic factors within racial/ethnic groups are being examined as risk factors not only for breast carcinoma mortality and survival but also as determinants of the rare of incidence. Social and economic factors have been associated in the literature predominantly with cancer mortality and s urvival. When socioeconomic status (SES) is considered, certain studies sug gest that racial disparities in breast carcinoma are smaller than when soci al and economic factors are examined alone, but these disparities still per sist. Sources of data fur this discussion include the National Cancer Insti tute (NCI) (the Surveillance, Epidemiology, and End Results (SEER) program, a group of population-based cancer registries that cover up to 14% of the U.S. population. SEER reports cancer incidence, mortality, and survival rat es), the U,S. Bureau of the Census, the National Center for Health Statisti cs (NCHS), and numerous articles from the scientific literature. Socioecono mic factors or SES can be considered "cross-cutting risk factors" (i.e., th ey can be related to the risk of developing breast carcinoma [rate of incid ence] as well as to the risk of dying [mortality] from this disease). They also are the risk factors that "cut across" racial and ethnic populations. Socioeconomic factors are related to breast carcinoma mortality and surviva l rates in multicultural women. Racial disparities in breast carcinoma mort ality and survival rates can be explained partially by stage distribution a t the time of diagnosis, which may be related to SES. For example, African- American women present with more advanced stage distributions for breast ca rcinoma than white women. Similarly women of lower SES present with higher stage disease Chan women of upper SES who present with more localized breas t carcinoma. The lack of data regarding the SES of dancer patients limits o ur understanding of the contributions of SES Co cancer incidence and mortal ity rates. SES appears to be related to breast carcinoma incidence, mortali ty, and survival rates. Breast carcinoma mortality is higher in women of lo wer SES. Additional research on SES, race, culture, and the relation of the se factors to cancer incidence rate is needed. (C) 2000 American Cancer Soc iety.