Abstract A76: Poverty as a carcinogen

Abstract

Abstract Background: The breast cancer mortality rate for black women in Duval County, FL (greater Jacksonville, FL) is the highest in the state of Florida, and is 38% higher for black women (36.7 per 100,000), than for white women (24.0 per 100,000). We sought to evaluate county specific breast cancer data, in an effort to better understand the disparities, and to begin designing effective targeted interventions to reduce these disparities. Methods: Data on female breast cancer cases from 2004-2010 were extracted using the Florida Cancer Data System (FCDS). This data was analyzed using traditional descriptive statistics. Additional classification included residence, race, insurance, and age. The primary outcomes were Stage at diagnosis, and time from diagnosis to treatment. Results: Using the FCDS, 6,579 new breast cancers were identified in Duval County from 2004 – 2010. Of these women, 73% were white, 24% black, 5% Hispanic, 2% Asian, and 2% unknown/other. Initially, univariate analyses identified black race, living in the urban core, being uninsured or having Medicaid insurance as having the worst outcomes in percentage of Stage IV disease at diagnosis and longer times from diagnosis to treatment (p<.01). However, using advanced multivariate analyses, race was no longer significant, and living in the urban core, being uninsured or having Medicaid insurance became predictors for higher percentage of Stage IV disease at diagnosis, and longer times from diagnosis to treatment (p<.001). Conclusion: Although initially black race was included as a significant predictor of poorer outcomes, advanced multivariate analyses revealed that living in the urban core, and lack of insurance or Medicaid funding was significantly associated with advanced stage at diagnosis and longer time from diagnosis to treatment in Duval County, Florida. Therefore, it seems that markers of poverty in Duval County, FL are better predictors of breast cancer disparities. These findings can inform targeted interventions to reduce the disparities in Duval County, FL. Citation Format: Sarah Rausch Osian, Laila Samiian, Dale Kraemer, Ryan Butterfield. Poverty as a carcinogen. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A76. doi:10.1158/1538-7755.DISP13-A76