The hypothesis that white women with breast cancer survive longer than black women with this disease was evaluated in a retrospective analysis of a population-based prospective follow-up study. All female residents of metropolitan Atlanta with a first diagnosis of primary breast cancer between 1 January 1978 and 31 December 1982 were eligible for inclusion. The study population of 2322 white and 536 black women was followed through the end of calendar year 1983 to determine vital status. Univariate, multivariate and excess death rate analyses were performed to evaluate race as a prognostic factor. Overall, the cumulative percentage of survivors at 3 years was 83% among whites, compared with 71% among blacks. The racial difference in survival was greatest among women with advanced disease, and a higher proportion of black women with advanced disease did not receive surgery. Even when the type of surgery and stage of disease were controlled, race was a significant prognostic factor.
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