scholarly journals Racial Disparities in Risk of Second Primary Cancers in Patients With Endometrial Cancer: Analysis of SEER Data

2011 ◽  
Vol 21 (2) ◽  
pp. 309-315 ◽  
Author(s):  
Ashley Sinclair Felix ◽  
Faina Linkov ◽  
George Larry Maxwell ◽  
Camille Ragin ◽  
Emanuela Taioli
Keyword(s):  
Endometrial Cancer ◽  
Black Women ◽  
General Population ◽  
Racial Disparities ◽  
Racial Differences ◽  
White Women ◽  
Gynecologic Cancer ◽  
The United States ◽  
Second Primary ◽  
Incidence And Mortality

Introduction:Endometrial cancer (EC) is the most common gynecologic cancer in the United States. Racial disparities in the incidence and mortality of this cancer are apparent; black women are less likely to develop this malignancy and yet are more likely to die when diagnosed. Racial differences of second primary cancer (SPC) have not been examined, and the goal of this study was to examine these differences.Methods:With the use of the National Cancer Institute's Surveillance, Epidemiology, and End Results database, SPC risk in white patients and black patients with EC was compared to the general population and to women with other primary cancers. Standardized incidence ratios (SIRs) of SPC (overall and by tumor site) with 95% confidence intervals were calculated. Poisson regression was used to estimate the race-specific risk of SPC in EC cases treated with radiotherapy versus nonirradiated cases.Results:The analysis included 11,047 patients with EC diagnosed between 1973 and 2007 that developed an SPC. Overall risk of SPC in white women with EC was significantly lower than that in the general population (SIR = 0.85; 95% CI, 0.84-0.87) but significantly higher in black women with EC (SIR = 1.19; 95% CI, 1.08-1.31). White women with EC treated with radiotherapy were more likely to develop SPC compared with nonirradiated cases (incidence rate ratio [IRR], 1.18; 95% CI, 1.14-1.23).Conclusions:This is the first analysis of race-specific SPC risk in EC cases, and it suggests differences between white women and black women with EC. Although exploratory, these data provide important clues about the etiology of SPC in patients with EC. This analysis also highlights the need for careful monitoring after diagnosis and treatment of EC.

Racial Disparities in Pregnancy-associated Intimate Partner Homicide

2021 ◽  
pp. 088626052199083
Author(s):  
Aaron J. Kivisto ◽  
Samantha Mills ◽  
Lisa S. Elwood
Keyword(s):  
Black Women ◽  
Ethnic Minority ◽  
Racial Disparities ◽  
White Women ◽  
The United States ◽  
Intimate Partner ◽  
Intimate Partner Homicide ◽  
Homicide Victimization ◽  
Increased Risk ◽  
Racial Ethnic

Pregnancy-associated femicide accounts for a mortality burden at least as high as any of the leading specific obstetric causes of maternal mortality, and intimate partners are the most common perpetrators of these homicides. This study examined pregnancy-associated and non-pregnancy-associated intimate partner homicide (IPH) victimization among racial/ethnic minority women relative to their non-minority counterparts using several sources of state-level data from 2003 through 2017. Data regarding partner homicide victimization came from the National Violent Death Reporting System, natality data were obtained from the Centers for Disease Control and Prevention’s National Center for Health Statistics, and relevant sociodemographic information was obtained from the U.S. Census Bureau. Findings indicated that pregnancy and racial/ethnic minority status were each associated with increased risk for partner homicide victimization. Although rates of non-pregnancy-associated IPH victimization were similar between Black and White women, significant differences emerged when limited to pregnancy-associated IPH such that Black women evidenced pregnancy-associated IPH rates more than threefold higher than that observed among White and Hispanic women. Relatedly, the largest intraracial discrepancies between pregnant and non-pregnant women emerged among Black women, who experienced pregnancy-associated IPH victimization at a rate 8.1 times greater than their non-pregnant peers. These findings indicate that the racial disparities in IPH victimization in the United States observed in prior research might be driven primarily by the pronounced differences among the pregnant subset of these populations.

Determinants of Racial Disparities in Female Incarceration Rates, 2000–2018

2021 ◽  
pp. 003464462110510
Author(s):  
Samuel L. Myers ◽  
William J. Sabol ◽  
Man Xu
Keyword(s):  
Black Women ◽  
Racial Disparities ◽  
African American Women ◽  
White Women ◽  
National Research Council ◽  
The United States ◽  
White Female ◽  
Opioid Use ◽  
Incarceration Rate ◽  
Women In Prison

In The Growth of Incarceration in the United States, the National Research Council documents the large and persistent racial disparities in imprisonment that accompanied the more than quadrupling of the U.S. incarceration rate since the 1980s. Largely unnoticed by policy makers and opinion leaders in recent years is an unprecedented decrease in the number of African American women incarcerated at the same time that the number of white women in prison has grown to new heights. The result of these recent changes is a near convergence in black-white female incarceration rates from 2000 to 2016. In some states, the changes occurred abruptly and almost instantaneously. In other states, the convergence has been gradual. We find that changes in the population composition—the fraction of the population that is black—was the major contributor to the decline in the disparity among women. We also find that race-specific differences in drug overdose deaths stemming from the recent increases in opioid use lowered the disparity by increasing the white female imprisonment rate and lowering it for black women.

scholarly journals Making cell culture more physiological: a call for a more comprehensive assessment of racial disparities in endothelial cell culture studies

2020 ◽  
Vol 318 (2) ◽  
pp. C238-C241 ◽  
Author(s):  
Austin T. Robinson ◽  
Marc D. Cook ◽  
Abbi D. Lane-Cordova
Keyword(s):  
Cell Culture ◽  
Endothelial Cell ◽  
Racial Disparities ◽  
Racial Differences ◽  
White Women ◽  
Microvascular Complications ◽  
The United States ◽  
Culture Studies ◽  
Endothelial Cell Function ◽  
Endothelial Cell Culture

In the United States, cardiovascular diseases (CVDs) are the leading cause of death and disproportionately affect ethnic and racial minority populations. Black individuals are more likely to develop advanced CVD and microvascular complications resulting in end-organ damage. Endothelial cell dysfunction leads to microvascular and macrovascular dysfunction and is predictive of the development of CVD. Black versus white racial disparities in in vivo and in vitro studies of endothelial cell function are well documented. However, race-related disparities in maternal environment and lifestyle may be a major unconsidered factor in racial differences in endothelial cell culture studies. Further, rates of hypertensive disorders of pregnancy are higher in black versus white women. These pregnancy complications may result in placental dysfunction, including excess production of inflammatory and antiangiogenic molecules that impair endothelial function. Therefore, studies that include other ethnic and racial minorities are needed, in addition to a more thorough characterization of endothelial cell donors and targeted cell culture studies (e.g., genotyping) to generate information that can be translated into effective preventive or treatment strategies for ethnic/racial disparities in CVD.

scholarly journals Health Care Segregation, Physician Recommendation, and Racial Disparities in BRCA1/2 Testing Among Women With Breast Cancer

2016 ◽  
Vol 34 (22) ◽  
pp. 2610-2618 ◽  
Author(s):  
Anne Marie McCarthy ◽  
Mirar Bristol ◽  
Susan M. Domchek ◽  
Peter W. Groeneveld ◽  
Younji Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Racial Disparities ◽  
Racial Differences ◽  
White Women ◽  
Physician Recommendation ◽  
Study Objective ◽  
Black And White ◽  
Physician Characteristics ◽  
White Patients

Purpose Racial disparities in BRCA1/2 testing have been documented, but causes of these disparities are poorly understood. The study objective was to investigate whether the distribution of black and white patients across cancer providers contributes to disparities in BRCA1/2 testing. Patients and Methods We conducted a population-based study of women in Pennsylvania and Florida who were 18 to 64 years old and diagnosed with invasive breast cancer between 2007 and 2009, linking cancer registry data, the American Medical Association Physician Masterfile, and patient and physician surveys. The study included 3,016 women (69% white, 31% black), 808 medical oncologists, and 732 surgeons. Results Black women were less likely to undergo BRCA1/2 testing than white women (odds ratio [OR], 0.40; 95% CI, 0.34 to 0.48; P < .001). This difference was attenuated but not eliminated by adjustment for mutation risk, clinical factors, sociodemographic characteristics, and attitudes about testing (OR, 0.66; 95% CI, 0.53 to 0.81; P < .001). The care of black and white women was highly segregated across surgeons and oncologists (index of dissimilarity 64.1 and 61.9, respectively), but adjusting for clustering within physician or physician characteristics did not change the size of the testing disparity. Black women were less likely to report that they had received physician recommendation for BRCA1/2 testing even after adjusting for mutation risk (OR, 0.66; 95% CI, 0.54 to 0.82; P < .001). Adjusting for physician recommendation further attenuated the testing disparity (OR, 0.76; 95% CI, 0.57 to 1.02; P = .06). Conclusion Although black and white patients with breast cancer tend to see different surgeons and oncologists, this distribution does not contribute to disparities in BRCA1/2 testing. Instead, residual racial differences in testing after accounting for patient and physician characteristics are largely attributable to differences in physician recommendations. Efforts to address these disparities should focus on ensuring equity in testing recommendations.

scholarly journals Racial Variation in Stroke Risk Among Women by Stroke Risk Factors

Stroke ◽  
2019 ◽  
Vol 50 (4) ◽  
pp. 797-804 ◽  
Author(s):  
Monik C. Jiménez ◽  
JoAnn E. Manson ◽  
Nancy R. Cook ◽  
Ichiro Kawachi ◽  
Sylvia Wassertheil-Smoller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Black Women ◽  
Racial Disparities ◽  
White Women ◽  
Stroke Risk ◽  
The United States ◽  
Incidence Rates ◽  
Rate Difference ◽  
Stroke Risk Factors ◽  
Causal Pathway

Background and Purpose— In the United States, black Americans exhibit a greater risk of stroke and burden of stroke risk factors than whites; however, it is unclear whether these stroke risk factors influence stroke risk differently across racial groups. Methods— In total, 126 018 participants of the Women’s Health Initiative (11 389 black and 114 629 white women), free of stroke and coronary heart disease at baseline (1994–1998), were followed through 2010. Participants completed baseline clinical exams with standardized measurements of blood pressure and anthropometrics, medication inventory and self-reported questionnaires on sociodemographics, behaviors/lifestyle, and medical history. Incident total, ischemic and hemorrhagic strokes were updated annually through questionnaires with medical record confirmation. Rate differences (per 100 000 person-years) and hazard ratios (HR) based on multivariable Cox models and were estimated. Results— Over a median of 13 years, 4344 stroke events were observed. Absolute incidence rates were higher in black than white women in each age group. In age-adjusted analyses, the risk of stroke was significantly higher among black compared with white women (HR=1.47, 95% CI, 1.33–1.63); adjustment for stroke risk factors, which may be on the causal pathway, attenuated the estimate. Racial disparities were greatest among women 50 to <60 years (HR=3.48; 95% CI, 2.31–5.26; rate difference =99) and diminished with increasing age (60 to <70 HR=1.80; 95% CI, 1.50–2.16; rate difference =107; ≥70 years: HR=1.26; 95% CI, 1.10–1.43; rate difference =87; P interaction <0.001). Black women 50 to <60 years remained at significantly higher risk than white women after adjustment for stroke risk factors (HR=1.76; 95% CI, 1.09–2.83). Conclusions— There was a moderately greater risk of total stroke among black compared with white women; however, racial disparities were greatest among women aged 50 to <60 years. Interventions targeted at younger black women may provide the greatest benefit in reducing disparities.

scholarly journals Racial Differences in Patterns of Care Among Medicaid-Enrolled Patients With Breast Cancer

2006 ◽  
Vol 2 (5) ◽  
pp. 205-213 ◽  
Author(s):  
Gretchen Kimmick ◽  
Fabian Camacho ◽  
Kristi Long Foley ◽  
Edward A. Levine ◽  
Rajesh Balkrishnan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Black Women ◽  
Adjuvant Chemotherapy ◽  
Racial Differences ◽  
Low Income ◽  
White Women ◽  
The United States ◽  
Adjuvant Radiation ◽  
Adjuvant Radiation Therapy

Purpose Suboptimal care among minority and low-income patients may explain poorer survival. There is little information describing patterns of health care in Medicaid-insured women with breast cancer in the United States. Using a previously created and validated database linking Medicaid claims and state-wide tumor registry data, we describe patterns of breast cancer care within a low-income population. Methods Sample characteristics were described by frequencies and means. Logistic regressions were used to determine predictors of type of surgery, use of radiation therapy after breast-conserving surgery (BCS), and use of adjuvant chemotherapy. Results The sample consisted of 974 women. The dataset included only white (58%) and black (42%) women. Sixty-seven percent were treated with mastectomy; 43% received adjuvant chemotherapy; and 67% of women receiving BCS received adjuvant radiation. In multivariate analysis, predictors of BCS were young age, black race, and smaller tumor size. Furthermore, there was a trend toward more black than white women with tumors 4 cm or larger having BCS (18% v 8%; P = .06). Race was not related to use of adjuvant radiation therapy after BCS or to use of adjuvant chemotherapy. Conclusion In this group of patients with breast cancer enrolled in Medicaid, black women were more likely than white women to have BCS. Race was not associated with adjuvant radiation therapy or chemotherapy use. Factors affecting the quality of care delivered to low-income and minority patients are complex, and better care lies in exploring areas that need improvement.

scholarly journals Subtype-Specific Breast Cancer Incidence Rates in Black versus White Men in the United States

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Hyuna Sung ◽  
Carol DeSantis ◽  
Ahmedin Jemal
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Black Women ◽  
Racial Differences ◽  
White Women ◽  
Triple Negative ◽  
Breast Cancer Subtype ◽  
Breast Cancer Incidence ◽  
The United States ◽  
Incidence Rates

Abstract Compared with white women, black women have higher incidence rates for triple-negative breast cancer but lower rates for hormone receptor (HR)–positive cancers in the United States. Whether similar racial difference occurs in male breast cancer is unclear. We examined racial differences in incidence rates of breast cancer subtypes defined by HR and human epidermal growth factor receptor 2 (HER2) by sex using nationwide data from 2010 to 2016. Among men, rates were higher in blacks than whites for all subtypes, with the black-to-white incidence rate ratios of 1.41 (95% confidence interval [CI ]= 1.32 to 1.50) for HR+/HER-, 1.65 (95% CI = 1.40 to 1.93) for HR+/HER2+, 2.62 (95% CI = 1.48 to 4.43) for HR-/HER2+, and 2.27 (95% CI = 1.67 to 3.03) for triple-negative subtype. Conversely, among women, rates in blacks were 21% lower for HR+/HER2- and comparable for HR+/HER2+ but 29% and 93% higher for HR-/HER2+ and triple-negative subtypes, respectively. Future studies are needed to identify contributing factors to the dissimilar racial patterns in breast cancer subtype incidence between men and women.

scholarly journals Identifying Genetic and Biological Determinants of Race-Ethnic Disparities in Stroke in the United States

Stroke ◽  
2020 ◽  
Vol 51 (11) ◽  
pp. 3417-3424 ◽  
Author(s):  
Debora Kamin Mukaz ◽  
Neil A. Zakai ◽  
Salvador Cruz-Flores ◽  
Louise D. McCullough ◽  
Mary Cushman
Keyword(s):  
United States ◽  
Risk Factors ◽  
Racial Disparities ◽  
Racial Differences ◽  
Ethnic Disparities ◽  
The United States ◽  
Current Evidence ◽  
Stroke Incidence ◽  
Incidence And Mortality ◽  
Traditional Risk Factors

In the United States, causes of racial differences in stroke and its risk factors remain only partly understood, and there is a long-standing disparity in stroke incidence and mortality impacting Black Americans. Only half of the excess risk of stroke in the United States Black population is explained by traditional risk factors, suggesting potential effects of other factors including genetic and biological characteristics. Here, we nonsystematically reviewed candidate laboratory biomarkers for stroke and their relationships to racial disparities in stroke. Current evidence indicates that IL-6 (interleukin-6), a proinflammatory cytokine, mediates racial disparities in stroke through its association with traditional risk factors. Only one reviewed biomarker, Lp(a) (lipoprotein[a]), is a race-specific risk factor for stroke. Lp(a) is highly genetically determined and levels are substantially higher in Black than White people; clinical and pharmaceutical ramifications for stroke prevention remain uncertain. Other studied stroke risk biomarkers did not explain racial differences in stroke. More research on Lp(a) and other biological and genetic risk factors is needed to understand and mitigate racial disparities in stroke.

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