SEVERE OBESITY AS AN EXPLANATORY FACTOR FOR THE BLACK WHITE DIFFERENCE IN STAGE AT DIAGNOSIS OF BREAST-CANCER/

Black women with breast cancer are less likely than white women to be diagnosed while their disease is still at a localized stage, Racial di fferences in the prevalence of obesity in the United States have also been documented. This study was undertaken to determine the extent to which the observed racial difference in stage at diagnosis of breast c ancer could be explained by racial differences in obesity, specificall y severe obesity, This was a population-based, retrospective study of 145 black women and 177 white women in Connecticut who were diagnosed with breast cancer between January 1987 and March 1989, Severe obesity was associated with both race and stage at diagnosis: Black women wer e significantly more likely than white women to be severely obese (26% vs. 7%, respectively), and severe obesity was significantly associate d with diagnosis at TNM stage II or greater (multivariate-adjusted odd s ratio = 3.10, 95% confidence interval (CI) 1.28-7.52). Adjustment fo r severe obesity in a logistic regression model reduced the risk of la ter stage at diagnosis in blacks relative to whites by 33%, from an od ds ratio of 1.98 (95% CI 1.22-3.19) to one of 1.66 (95% CI 1.01-2.73). The higher prevalence of severe obesity among black women may play an important role in explaining their relative disadvantage in stage at diagnosis of breast cancer.