Is Sex a Contributing Factor to Mortality Disparity in Breast Cancer?
Posted: Wednesday, October 30, 2019
According to a nationwide, registry-based cohort study published in JAMA Oncology by Fei Wang, MD, PhD, of Vanderbilt University Medical Center, and colleagues, men who have been diagnosed with breast cancer have a higher mortality rate than women who have received the same diagnosis. The study sought to determine the relationship between sex and mortality and factors contributing to any disparity.
Using the National Cancer Database, the investigators identified and analyzed data from 1,816,733 patients who had received a breast cancer diagnosis between January 1, 2004, and December 31, 2014. The study included 16,025 men, with an average age of 63.3 years, and 1,800,708 women, with an average age of 59.9 years. Comparatively, the men (n = 16,025) had higher mortality rates overall. The male cohort experienced an overall survival rate of 45.8%, a 3-year survival rate of 86.4%, and a 5-year survival rate of 77.6%, whereas women had an overall survival rate of 60.4%, a 3-year rate of 91.7%, and a 5-year rate of 86.4%.
According to the study authors, the 63.3% excess mortality rate in men was associated with undertreatment and clinical characteristics, with a greater number of excess deaths attributed to such factors in the first 3 years following diagnosis (66.0%) as well as in all patients with stage 1 (30.5%) or stage II (13.6%) disease.
“Such disparity appeared to persist after accounting for clinical characteristics, treatment factors, and access to care, suggesting that other factors (particularly additional biological attributes, treatment compliance, and lifestyle factors) should be identified to help in eliminating this disparity,” concluded Dr. Wang and colleagues.
Disclosure: The study authors’ disclosure information may be found at jamanetwork.com.