ER/PR negative tumors associated with insurance status

Nov 18 2008

African-American women are at a higher risk for ER/PR negative breast cancer.

A new study, to be presented at the American Association for Cancer Research's Seventh Annual International Conference on Frontiers in Cancer Prevention Research, found that race, socioeconomic characteristics and other tumor characteristics are all important predictors of having ER/PR negative breast cancer.

ER/PR negative breast cancer has a poorer prognosis than hormonally-responsive cancer because treatment options are more limited.

In statistical models adjusted only for age, the study found that women who are uninsured or insured through Medicaid were 1.5 times more likely to have ER/PR negative tumors. Women who resided in low education versus high education zip codes were 1.6 times more likely to be diagnosed with ER/PR negative tumors. These findings were attenuated after controlling for race and other tumor characteristics which are highly associated with ER/PR status.

The risk of ER/PR negative breast cancers for African-American women dropped from 2.26 to 1.85 after controlling for socioeconomic status, stage at diagnosis, tumor size and histologic type.

"Hopefully, these findings will make us more aware that this more severe type of breast cancer is hitting minority and medically underserved women hardest, and we need to work toward finding prevention and therapeutic strategies," said Elizabeth Ward, Ph.D., director of cancer surveillance research at the American Cancer Society.

Ward and colleagues studied the relationship between race, socioeconomics and breast cancer using the National Cancer Database, which collects data for approximately 1,500 cancer hospitals, representing 70 percent of cancer patients in the United States.

After excluding those women with missing information on ER/PR status, researchers were left with 175,820 women who were diagnosed with breast cancer.

"It appears that multiple factors contribute to the risk for ER/PR negative breast cancer. Some of these risk factors appear to be more common in poor and African-American women," Ward said.