Understanding the Persistence Breast Cancer Racial Disparities
Principal Investigator
Name
Kelly Hirko
Degrees
PHD, MPH
Institution
Michigan State University
Position Title
Assistant Professor, Department of Epidemiology & Biostatistics
Email
About this CDAS Project
Study
PLCO
(Learn more about this study)
Project ID
PLCO-809
Initial CDAS Request Approval
Jul 15, 2021
Title
Understanding the Persistence Breast Cancer Racial Disparities
Summary
Despite recent progress in early detection and novel therapies, breast cancer remains the leading cause of cancer-related mortality among women worldwide. Persistent disparities in breast cancer outcomes are also noted, with African American (AA) women in the U.S. exhibiting poorer prognosis and survival than their Caucasian counterparts. Poorer BC outcomes in AA women have partly been attributed to factors like late cancer stage at diagnosis, antagonistic tumor characteristics, and limited access to high-quality prevention, early detection, and treatment. However, few attempts have been made to extensively quantify the degree of confounding for the race effect induced by these factors. A popular approach for evaluating the potential contributors to observed differences in many health outcomes has been to compare unadjusted and adjusted effects based on regression estimates between blacks and whites. Other existing literature focus on predisposing genetic factors associated with BC etiology in black women. But this emphasis on heritable risk factors fails to consider the potential effects of the biological changes in DNA that may have resulted from differential exposures in lived experience, exposure to stressors like institutional racism, and physical environments over the life course. Hence, it is unclear to what extent the variations in risk factor distributions explain the persistence of racial disparities. Addressing such issues calls for an approach that quantifies confounding sources while comparing health outcomes between populations.
Aims
To assess the dynamic role of factors contributing to the persistence of breast cancer racial disparities between AA and White women across time. The specific aims of this proposal are to:
• Describe trends in risk factor data (demographics, tumor characteristics, treatment, etc) over time between AA and white female BC cases.
• Use a counterfactual approach to understand how breast cancer outcomes like mortality/survival might differ between these groups.
Collaborators
Dr. Kelly Hirko, Assistant Professor, Department of Epidemiology and Biostatistics, Michigan State University
Dr. Dorothy Pathak, Department of Epidemiology and Biostatistics, Michigan State University
Dr. David Todem, Department of Epidemiology and Biostatistics, Michigan State University