Relationship between documentation status and survival for medically underserved Hispanic breast cancer patients

J Surg Res. 2013 Apr;180(2):284-9. doi: 10.1016/j.jss.2012.04.072. Epub 2012 May 16.

Abstract

Background: Undocumented immigrants have been shown to be predisposed to worse clinical outcomes than the general population. This study examines survival in socioeconomically disadvantaged Hispanic documented and undocumented breast cancer patients.

Methods: Analysis of a prospective breast cancer database of patients treated in a safety-net hospital system. Overall survival was the primary outcome, and advanced stage at diagnosis (regional and metastatic) was a secondary outcome. Survival analysis and multivariate regression modeling were performed.

Results: Seven hundred fifty-one breast cancer patients were identified. Undocumented patients presented at an earlier age and were likely to present with advanced stage. After adjusting for covariates, undocumented status was not associated with increased mortality. The diagnosis-to-treatment interval was significantly longer in undocumented patients.

Conclusions: Despite undocumented patients presenting at a younger age, they have similar mortality compared with documented patients. This finding is partly explained by the local treatment afforded by undocumented patients, further studies are necessary to detail the reasons for these differences in presentation and outcome.

MeSH terms

  • Adult
  • Breast Neoplasms / ethnology*
  • Breast Neoplasms / mortality*
  • Breast Neoplasms / pathology
  • Documentation
  • Emigrants and Immigrants*
  • Female
  • Healthcare Disparities*
  • Hispanic Americans*
  • Humans
  • Middle Aged
  • Neoplasm Staging
  • Proportional Hazards Models
  • Vulnerable Populations*