Date of Conferral

1-1-2011

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Mary Lou Gutierrez

Abstract

Although the incidence of breast cancer in women under 40 years of age is somewhat rare, young women tend to present with cancer that is more advanced and with poorer prognostic characteristics. This research will be important to providers, women and their families and those seeking to clarify screening guidelines. The purpose of this quantitative, retrospective, cohort study was to evaluate differences in prognostic characteristics by socioeconomic position (SIP). The cohort was comprised of females aged 18 to 39 with a primary diagnosis of breast cancer. Data were obtained from the Surveillance, Epidemiology and End Results registry for all primary breast cancers reported between 2001 and 2006 (n = 14,696). Hierarchical regression analysis was performed to assess to what extent SEP had an independent effect on tumor size and cancer summary stage upon diagnosis, and overall survival. SEP was found to be a significant predictor of tumor size and summary stage at the time of diagnosis. As cancer summary stage increases by 1 unit, women were .14 times as likely to have a tumor size of less than 2 cm versus a tumor size of greater than 5 cm. As SEP increases by 1 unit, the likelihood of having a tumor size of less than 2 cm versus greater than 5 cm increases by a factor of 1.14. SEP was not a significant predictor of survival time. The results of this study have the potential to promote positive social change by advancing the understanding of breast cancer in young women, as well as raise awareness of socioeconomic, racial and clinical inequalities. In addition, it may assist researchers and policy makers clearly defined formal screening guidelines for young women in higher-risk subgroups based on socioeconomic position.

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