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Jim Crow and estrogen-receptor-negative breast cancer: US-born black and white non-Hispanic women, 1992-2012
Journal article   Peer reviewed

Jim Crow and estrogen-receptor-negative breast cancer: US-born black and white non-Hispanic women, 1992-2012

Nancy Krieger, Jaquelyn L. Jahn and Pamela D. Waterman
Cancer causes & control, v 28(1), pp 49-59
01 Jan 2017
PMID: 27988896

Abstract

Life Sciences & Biomedicine Oncology Public, Environmental & Occupational Health Science & Technology
It is unknown whether Jim Crow-i.e., legal racial discrimination practiced by 21 US states and the District of Columbia and outlawed by the US Civil Rights Act in 1964-affects US cancer outcomes. We hypothesized that Jim Crow birthplace would be associated with higher risk of estrogen-receptor-negative (ER-) breast tumors among US black, but not white, women and also a higher black versus white risk for ER- tumors. We analyzed data from the SEER 13 registry group (excluding Alaska) for 47,157 US-born black non-Hispanic and 348,514 US-born white non-Hispanic women, aged 25-84 inclusive, diagnosed with primary invasive breast cancer between 1 January 1992 and 31 December 2012. Jim Crow birthplace was associated with increased odds of ER- breast cancer only among the black, not white women, with the effect strongest for women born before 1965. Among black women, the odds ratio (OR) for an ER- tumor, comparing women born in a Jim Crow versus not Jim Crow state, equaled 1.09 (95% confidence interval [CI] 1.06, 1.13), on par with the OR comparing women in the worst versus best census tract socioeconomic quintiles (1.15; 95% CI 1.07, 1.23). The black versus white OR for ER- was higher among women born in Jim Crow versus non-Jim Crow states (1.41 [95% CI 1.13, 1.46] vs. 1.27 [95% CI 1.24, 1.31]). The unique Jim Crow effect for US black women for breast cancer ER status underscores why analysis of racial/ethnic inequities must be historically contextualized.

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being
#5 Gender Equality

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Web of Science research areas
Oncology
Public, Environmental & Occupational Health
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