Résumé :
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[BDSP. Notice produite par INIST QcSR0xJM. Diffusion soumise à autorisation]. Context. - Breast cancer mortality is higher among African American women than among white women in the United States, but the reasons for the racial difference are not known. Objective. - To evaluate the influence of socioeconomic and cultural factors on the racial difference in breast cancer stage at diagnosis. Design. - Case-control study of patients diagnosed as having breast cancer at the University Medical Center of Eastem Carolina from 1985 through 1992. Setting. - The major health care facility for 2 rural counties in eastern North Carolina. Subjects. - Five hundred forty of 743 patients with newly diagnosed breast cancer and 414 control women from the community matched by age, race, and area of residence. Main Outcome Measures. - Breast cancer stage at diagnosis. Results. Of the 540 patients, 94 (17.4%) presented with TNM stage III or IV disease. The following demographic and socioeconomic factors were significant predictors of advanced stage : being African American (odds ratio [OR], 3.0 ; 95% confidence interval [Cl], 1.9-4.7) ; having low income (OR, 3.7 ; 95% Cl, 2.1-6.5) ; never having been married (OR, 2.9 ; 95% Cl, 1.4-5.9) ; having no private health insurance (OR, 2.5 ; 95% Cl, 1.6-4.0) ; delaying seeing a physician because of money (OR, 1.6 ; 95% Cl, 1.1-2.5) ; or lacking transportation (OR, 2.0 ; 95% Cl, 1.2-3.6). Univariate analysis also revealed a large number of cultural beliefs to be significant predictors. (...)
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