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Paula M. Lantz, PhD, Mahasin Mujahid, MS, Kendra Schwartz, MD, MHSA, Nancy K. Janz, PhD, Angela Fagerlin, PhD, Barbara Salem, MSW, Lihua Liu, PhD, Dennis Deapen, DrPH and Steven J. Katz, MD, MPH

At the time of the study, Paula M. Lantz was with the Department of Health Management and Policy and the Institute for Social Research, University of Michigan, Ann Arbor. Mahasin Mujahid was with the Department of Epidemiology, University of Michigan, Ann Arbor. Kendra Schwartz was with the Department of Family Medicine and the Barbara Ann Karmanos Cancer Institute at Wayne State University, Detroit, Michigan. Nancy K. Janz was with the Department of Health Behavior/Health Education, University of Michigan, Ann Arbor. Angela Fagerlin and Barbara Salem were with the Department of Medicine, University of Michigan, Ann Arbor. Lihua Liu and Dennis Deapen were with the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles. Steven J. Katz was with the Departments of Medicine and Health Management and Policy, University of Michigan, and the VA Health Services Research and Development, Veterans Affairs, Ann Arbor Healthcare System, Ann Arbor.

Correspondence: Requests for reprints should be sent to Paula M. Lantz, Department of Health Management and Policy, 109 Observatory, University of Michigan School of Public Health, Ann Arbor, MI, 48109–2029 (e-mail: plantz{at}umich.edu).

Objectives. Previous research has generally found that racial/ethnic differences in breast cancer stage at diagnosis attenuate when measures of socioeconomic status are included in the analysis, although most previous research measured socioeconomic status at the contextual level. This study investigated the relation between race/ethnicity, individual socioeconomic status, and breast cancer stage at diagnosis.

Methods. Women with stage 0 to III breast cancer were identified from population-based data from the Surveillance, Epidemiology, and End Results tumor registries in the Detroit and Los Angeles metropolitan areas. These data were combined with data from a mailed survey in a sample of White, Black, and Hispanic women (n=1700). Logistic regression identified factors associated with early-stage diagnosis.

Results. Black and Hispanic women were less likely to be diagnosed with early-stage breast cancer than were White women (P< .001). After control for study site, age, and individual socioeconomic factors, the odds of early detection were still significantly less for Hispanic women (odds ratio [OR]=0.45) and Black women (OR = 0.72) than for White women. After control for the method of disease detection, the White/Black disparity attenuated to insignificance; the decreased likelihood of early detection among Hispanic women remained significant (OR=0.59).

Conclusion. The way in which racial/ethnic minority status and socioeconomic characteristics produce disparities in women’s experiences with breast cancer deserves further research and policy attention.