Abstract
Objective. The objectives of the study were to detect high-risk areas and to examine how racial and ethnic status affect the geographic distribution of female breast cancer mortality in Texas. Analyses were based on county-level data for the years from 2000 to 2008. Materials and Methods. Breast cancer mortality data were obtained from the Texas Cancer Registry, and the Spatial Scan Statistics method was used to run Purely Spatial Analyses using the Discrete Poisson, Bernoulli, and Multinomial models. Results and Conclusions. Highest rates of female breast cancer mortality in Texas have shifted over time from southeastern areas towards northern and eastern areas, and breast cancer mortality at the county level is distributed heterogeneously based on racial/ethnic status. Non-Hispanic blacks were at highest risk in the northeastern region and lowest risk in the southern region, while Hispanics were at highest risk in the southern region along the border with Mexico and lowest risk in the northeastern region.
Highlights
Breast cancer is the most common cancer and second leading cause of cancer mortality in the United States and Texas [1]
This indicates that the geographic distribution of female breast cancer mortality at the county level has shifted over time from the southeast towards northern and eastern areas in Texas
We identified one cluster in northeast Texas that had higher risk of breast cancer mortality for non-Hispanic blacks (NHB) compared to non-Hispanic whites (NHW) though the Bernoulli model analysis
Summary
Breast cancer is the most common cancer and second leading cause of cancer mortality in the United States and Texas [1]. There is considerable variation in the rates of breast cancer mortality at the county level. The reported highest and lowest age-adjusted mortality rates for breast cancer from 2000 to 2008 for Texas at the county level were 41.9 and 16.1 per 100,000, respectively [2]. Mortality rates for female breast cancer were approximately 30% higher during 1992–2001 [3] and 50% higher during 2001–2005 [4] among black women compared to white women. Rates were lower among Hispanic compared to white women [3, 4] Both black and Hispanic women were found to have significantly increased relative risk of breast cancer mortality compared to non-Hispanic white women during 1992–2000 [3, 5]
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