Women from non-English speaking backgrounds living in Australia present with later stage breast cancer: A population study

Abstract

17043 Background: Ethnicity may influence both the incidence and prognosis of breast cancer. We have conducted an analysis to determine if women from non-English speaking backgrounds (NESB) living in New South Wales (NSW), Australia, present with later stage breast cancer compared to women from English speaking backgrounds (ESB); and to determine whether there is an impact on their survival. Methods: Data from the NSW Cancer Registry (1980 to 2004) was used to identify women with their first presentation of breast cancer. Stage of breast cancer was classified as early (insitu or localized) versus late (regional nodal or distant metastatic spread) according to registry definitions. Country of birth was used as a surrogate for language status. Stage at diagnosis was compared between ESB versus NESB women. Logistic regression was used to determine the odds of late stage disease and Cox regression to determine survival outcomes Results: 60,676 of 75,583 cases were considered suitable for analysis. Of these 16.64% were NESB. Accounting for potential confounding variables, NESB women were more likely to have late stage disease than ESB women (OR= 1.12; 95% CI, 1.07 to 1.17). Analysis by geographical region of birth revealed women born in Middle Eastern region were most likely to have late stage disease at presentation (OR 1.41; 95% CI, 1.25 to 1.60). In multivariable analysis of all-cause mortality NESB women had a superior overall survival (HR 0.90; 95% CI 0.87 to 0.94) compared to ESB women, however, there was no difference in breast cancer specific survival between these groups by univariate analysis (logrank p=0.46). Conclusions: In New South Wales, Australia, NESB women have a delayed presentation with breast cancer as indicted by more advanced stage. However, stage-adjusted, breast cancer specific survival in NESB women is similar to the ESB women. Further studies are required to determine the reasons for delayed detection for NESB women. No significant financial relationships to disclose.