OBJECTIVES: This paper aims to investigate the effect of socioeconomic status, as measured by education, on the survival of breast cancer patients treated on 10 studies conducted by the Cancer and Leukemia Group B. METHODS: Sociodemographic data, including education, were reported by the patient at trial enrollment. Cox proportional hazards model stratified by treatment arm/study was used to examine the effect of education on survival among patients with early stage and metastatic breast cancer, after adjustment for known prognostic factors. RESULTS: The patient population included 1020 patients with metastatic disease and 5146 patients with early stage disease. Among metastatic patients, factors associated with poorer survival in the final multivariable model included African American race, never married, negative estrogen receptor status, prior hormonal therapy, visceral involvement, and bone involvement. Among early stage patients, significant factors associated with poorer survival included African American race, separated/widowed, post/perimenopausal, negative/unknown estrogen receptor status, negative progesterone receptor status, >4 positive nodes, tumor diameter >2 cm, and education. Having not completed high school was associated with poorer survival among early stage patients. Among metastatic patients, non-African American women who lacked a high school degree had poorer survival than other non-African American women, and African American women who lacked a high school education had better survival than educated African American women. CONCLUSIONS: Having less than a high school education is a risk factor for death among patients with early stage breast cancer who participated in a clinical trial, with its impact among metastatic patients being less clear. Post-trial survivorship plans need to focus on women with low social status, as measured by education.
OBJECTIVES: This paper aims to investigate the effect of socioeconomic status, as measured by education, on the survival of breast cancerpatients treated on 10 studies conducted by the Cancer and Leukemia Group B. METHODS: Sociodemographic data, including education, were reported by the patient at trial enrollment. Cox proportional hazards model stratified by treatment arm/study was used to examine the effect of education on survival among patients with early stage and metastatic breast cancer, after adjustment for known prognostic factors. RESULTS: The patient population included 1020 patients with metastatic disease and 5146 patients with early stage disease. Among metastatic patients, factors associated with poorer survival in the final multivariable model included African American race, never married, negative estrogen receptor status, prior hormonal therapy, visceral involvement, and bone involvement. Among early stage patients, significant factors associated with poorer survival included African American race, separated/widowed, post/perimenopausal, negative/unknown estrogen receptor status, negative progesterone receptor status, >4 positive nodes, tumor diameter >2 cm, and education. Having not completed high school was associated with poorer survival among early stage patients. Among metastatic patients, non-African American women who lacked a high school degree had poorer survival than other non-African American women, and African American women who lacked a high school education had better survival than educated African American women. CONCLUSIONS: Having less than a high school education is a risk factor for death among patients with early stage breast cancer who participated in a clinical trial, with its impact among metastatic patients being less clear. Post-trial survivorship plans need to focus on women with low social status, as measured by education.
Authors: A William Blackstock; James E Herndon; Electra D Paskett; Michael C Perry; Stephen L Graziano; Joseph J Muscato; Michael P Kosty; Wallace L Akerley; Jimmie Holland; Stewart Fleishman; Mark R Green Journal: J Natl Cancer Inst Date: 2002-02-20 Impact factor: 13.506
Authors: Blase N Polite; Constance Cirrincione; Gini F Fleming; Donald A Berry; Andrew Seidman; Hyman Muss; Larry Norton; Charles Shapiro; Kamal Bakri; Kelly Marcom; Diana Lake; Joel H Schwartz; Clifford Hudis; Eric P Winer Journal: J Clin Oncol Date: 2008-06-01 Impact factor: 44.544
Authors: Jeffrey H Silber; Paul R Rosenbaum; Richard N Ross; Joseph G Reiter; Bijan A Niknam; Alexander S Hill; Diana M Bongiorno; Shivani A Shah; Lauren L Hochman; Orit Even-Shoshan; Kevin R Fox Journal: Milbank Q Date: 2018-12 Impact factor: 4.911
Authors: Esther M John; Valerie McGuire; Allison W Kurian; Jocelyn Koo; Salma Shariff-Marco; Scarlett Lin Gomez; Iona Cheng; Theresa H M Keegan; Marilyn L Kwan; Leslie Bernstein; Cheryl Vigen; Anna H Wu Journal: Cancer Epidemiol Biomarkers Prev Date: 2020-12-18 Impact factor: 4.090
Authors: Ki-Tae Hwang; Woochul Noh; Se-Heon Cho; Jonghan Yu; Min Ho Park; Joon Jeong; Hyouk Jin Lee; Jongjin Kim; Sohee Oh; Young A Kim Journal: Cancer Res Treat Date: 2017-02-02 Impact factor: 4.679
Authors: Esmat Davoudi Monfared; Maryam Mohseny; Farzaneh Amanpour; Alireza Mosavi Jarrahi; Mohammad Moradi Joo; Mohammad Ali Heidarnia Journal: Asian Pac J Cancer Prev Date: 2017-04-01