Update: Special Research into Breast Cancer Disparities

A New Collaboration and a New Tool

Catherine Thomsen, M.P.H., Special Research Initiatives Project Lead

The California Breast Cancer Research Program is funding new research into the reasons why some groups of women bear a greater burden of this disease. With the assistance of national and state experts and advocates, we selected projects for funding that leverage the state’s unique and diverse resources in ways that can steer breast cancer research in new, promising directions.

Two of these initiatives are underway. Their goals: to not only increase knowledge about the reasons for disparities in breast cancer incidence and outcomes, but also identify solutions that will lead us toward true prevention of the disease.

Collaborative to Study Survival

Differences in survival between racial and ethnic groups has been of interest for many years, but we still don’t know why women from some groups live longer with breast cancer than others, even when they are diagnosed at the same stage and with the same kind of cancer. We are funding six investigators representing eight different studies to collaborate on discovering why.

This project, entitled Understanding Racial and Ethnic Differences in Stage-Specific Breast Cancer Survival, is being facilitated by Anna Wu, Ph.D., of University of Southern California and the Breast Cancer in Asian American Women Study. Other collaborators and their studies include:

The data in these eight studies represent over 13,000 California women with and without breast cancer, including significant numbers of African American, Hispanic/Latina, Japanese American, Chinese American, Filipina American, and white women, with smaller numbers of American Indian/Alaska Native women.

Together, the researchers are exploring the feasibility of combining these studies to create a unique database. So far, the researchers are looking at elements that the various studies have in common. Each collects information about physical characteristics, such as weight and height, as well as diet and exercise. They also know which women have or had other illnesses, and what types of tumors they have had. And they know about their social and economic position. By looking at differences in these and possibly other factors within a very diverse group of women, the six collaborators are hoping to identify reasons for disparate survival rates between racial and ethnic groups and subgroups.

By combining data and identifying important questions, these researchers can apply for additional CBCRP funding in 2010. Their ultimate aim: to identify social or physical environmental factors that impact why some groups of women are more likely to die from breast cancer. Eventually this could lead to identifying actions women can take, or changes we can make in our physical and social environments, that will lower breast cancer death rates.

Creating Tools to Study Breast Cancer

Another way to better understand why some women are more likely to get, and die from, breast cancer is to improve our data. In order to make studies like those above more useful in the future, Scarlet Lin Gomez, Ph.D., of the Northern California Cancer Center, is working to develop new Demographic Questions for California Breast Cancer Research. We are funding Dr. Gomez and her team of national and state experts and community advocates to create a core set of standard questions to look at the multiple factors that could impact breast cancer incidence, progression and outcomes. The core variables include race/ ancestry, ethnicity, birthplace/migration history, income, education, disability, and sexuality. They are also creating extended questions for researchers who are interested in delving more deeply into one or more of these areas.

Dr. Gomez and her team are developing a tool that empowers researchers to find out more about which women are most affected by breast cancer, in order to reduce that burden. The questions in this survey tool are being pretested in focus groups to be sure they are understood correctly. The English survey tool will be translated into several languages commonly spoken in California: Spanish, Mandarin and Cantonese Chinese, and Tagalog. The survey will then be pilot-tested in telephone interviews and self-administered questionnaires.

This study builds on California’s national leadership in collecting information about who gets cancer, including breast cancer. Scientists will be required to use these standard questions in future research that we fund, and we will encourage their use by other researchers. With uniformly gathered data, scientists can more effectively compare their results regarding why and how breast cancer affects some women more than others, leading to new knowledge about how the unequal burden of breast cancer in the population can be eliminated.