Association of individual and neighborhood SES with breast cancer–specific mortality by race/ethnicity: HRs with 95% CIs, San Francisco Bay Area, 1995 to 2008 (with follow-up through 2009)
| Non-Hispanic white | African-American | Hispanic | Asian-American | |||||
|---|---|---|---|---|---|---|---|---|
| Base modela | Base + education + SES modelb | Base modela | Base + education + SES modelb | Base modela | Base + education + SES modelb | Base modela | Base + education + SES modelb | |
| SES variables | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) |
| Education | ||||||||
| College degree+ | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Vocational/some college | 0.87 (0.59–1.29) | 0.87 (0.59–1.29) | 0.74 (0.49–1.14) | 0.70 (0.45–1.09) | 1.41 (0.83–2.37) | 1.36 (0.80–2.32) | 1.11 (0.59–2.09) | 0.93 (0.49–1.76) |
| = High school degreec | 1.15 (0.75–1.77) | 1.14 (0.73–1.77) | 0.65 (0.39–1.10) | 0.56 (0.32–1.00) | 1.17 (0.66–2.08) | 1.09 (0.60–2.00) | 1.93 (1.09–3.43) | 1.23 (0.66–2.31) |
| <High school degree | 0.97 (0.59–1.60) | 0.83 (0.49–1.40) | 1.37 (0.82–2.27) | 1.22 (0.70–2.13) | ||||
| Ptrend | 0.70 | 0.74 | 0.61 | 0.31 | 0.43 | 0.86 | 0.04 | 0.51 |
| Neighborhood SESe | ||||||||
| Q5-high SES | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Q4 | 1.12 (0.76–1.65) | 1.09 (0.73–1.62) | 0.63 (0.37–1.09) | 0.67 (0.39–1.15) | 0.85 (0.54–1.35) | 0.84 (0.53–1.36) | 2.63 (1.51–4.60) | 2.55 (1.42–4.58) |
| Q3 | 1.02 (0.61–1.70) | 1.00 (0.59–1.68) | 0.78 (0.45–1.37) | 0.88 (0.50–1.57) | 1.05 (0.67–1.66) | 1.03 (0.63–1.69) | 2.97 (1.47–5.98) | 2.78 (1.36–5.71) |
| Q2d | 1.08 (0.41–2.87) | 1.05 (0.40–2.75) | 0.95 (0.60–1.52) | 1.08 (0.67–1.74) | 1.41 (0.87–2.30) | 1.38 (0.83–2.30) | 4.25 (1.99–9.08) | 3.91 (1.72–8.91) |
| Q1-low SES | 1.20 (0.71–2.02) | 1.42 (0.81–2.47) | 1.48 (0.78–2.84) | 1.47 (0.74–2.91) | ||||
| Ptrend | 0.75 | 0.80 | 0.17 | 0.10 | 0.10 | 0.14 | 0.01 | 0.01 |
| Education and nSESf | ||||||||
| ≥Some college, high nSES | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | ||||
| ≥Some college, low nSES | 0.78 (0.41–1.50) | 1.45 (0.99–2.14) | 1.08 (0.59–1.97) | 2.26 (1.14–4.49) | ||||
| ≤HS degree, high nSES | 1.09 (0.69–1.73) | 1.25 (0.65–2.43) | 0.84 (0.52–1.34) | 1.74 (0.88–3.44) | ||||
| ≤HS degree, low nSES | 1.52 (0.82–2.82) | 1.11 (0.72–1.70) | 1.24 (0.83–1.86) | 2.82 (1.29–6.14) | ||||
NOTE: Bold font refers to statistically significant associations.
↵aAdjusted for age at diagnosis (continuous), year of diagnosis (continuous), study eligibility (FRBC high risk, case–control, FRBC sporadic), nodal involvement (no, yes, unknown), histology (ductal, lobular, other), histologic grade (1–4, unknown), joint ERPR status (ER−PR−, ER+, or PR+, unknown), type of surgery (none, lumpectomy, mastectomy, NOS, unknown), radiation (no, yes, unknown), chemotherapy (no, yes, unknown), subsequent primary tumor (yes, no) and clustering by block group, and stratified by AJCC stage (I–IV, unknown).
↵bAdjusted for covariates of model 1 and clustering by block group (individual education and neighborhood SES in the same model), and stratified by AJCC stage (I–IV, unknown).
↵cEducation levels (<high school graduate and high school graduate) collapsed as ≤ high school graduate for non-Hispanic whites and Asian-Americans because of small sample sizes.
↵dNeighborhood SES quintiles 1 and 2 were collapsed for non-Hispanic whites and Asian-Americans because of small sample sizes.
↵eNeighborhood SES was measured using a composite measure of 7 Census indicator measures known as the YOST SES Index (29).
↵fHS, high school. Education levels (<high school graduate and high school graduate) collapsed as ≤ high school graduate. Neighborhood SES levels collapsed as Q1 to Q3: low SES; Q4 to Q5: high SES.