Background and Aim: The purpose of this study is to examine differences in survival for black and non-black women diagnosed with (CC) and treated in a developing country.
Methods: Medical records of CC patients treated from 2006-2009 at the Brazilian National Cancer Institute were reviewed. Differences in survival were evaluated between black and non-black women. Chi-square tests and Odds Ratios (OR) with 95% confidence intervals (95% CI) were calculated. Survival was examined using the Kaplan–Meier method. Single and multivariate Cox proportional hazards modeling was used to estimate Hazard Ratios (HR) with 95% CI.
Results: The study sample included 1,482 women, including 188 (12.7%) who were black, 1,209 (81.6%) who were non-black and 85 (5.7%) not specified. There were no significant differences between black and non-black patients regarding age (p=0.26), number of comorbidities (p=0.20), performance status (p=0.149) or stage at diagnosis (p=0.15). Hemoglobin level at diagnosis lower than 12g/dl was more frequent in black women (56.5% vs 45.6% p=0.008), they less frequently received cancer-directed surgery (18.1% vs 28.3%, p=0.005) and lymphadenectomy (10.6% vs 18.5%, p=0.027). There were no differences in the amount of chemotherapy or radiotherapy received by black and non-black women. Overall, black women had a hazard ratio (HR) of 1.5 (95% confidence interval=1.2-1.8) of CC mortality compared with non-blacks. After adjusting for hemoglobin levels, there was no significant difference in CC specific mortality.
Conclusions: In this cohort, black women presented worse survival compared to non-black counterparts, but there was no difference after adjusting for hemoglobin level, which is lower in black CC patients.