Disparities in breast cancer survival in the United States (2001-2009): Findings from the CONCORD-2 study

Jacqueline W. Miller, Judith Lee Smith, A. Blythe Ryerson, Thomas C. Tucker, Claudia Allemani

Research output: Contribution to journalArticlepeer-review

57 Scopus citations


BACKGROUND: Reducing breast cancer incidence and achieving equity in breast cancer outcomes remains a priority for public health practitioners, health care providers, policy makers, and health advocates. Monitoring breast cancer survival can help evaluate the effectiveness of health services, quantify inequities in outcomes between states or population subgroups, and inform efforts to improve the effectiveness of cancer management and treatment. METHODS: We analyzed breast cancer survival using individual patient records from 37 statewide registries that participated in the CONCORD-2 study, covering approximately 80% of the US population. Females were diagnosed between 2001 and 2009 and were followed through December 31, 2009. Age-standardized net survival at 1 year, 3 years, and 5 years after diagnosis was estimated by state, race (white, black), stage at diagnosis, and calendar period (2001-2003 and 2004-2009). RESULTS: Overall, 5-year breast cancer net survival was very high (88.2%). Survival remained remarkably high from 2001 through 2009. Between 2001 and 2003, survival was 89.1% for white females and 76.9% for black females. Between 2004 and 2009, survival was 89.6% for white females and 78.4% for black females. CONCLUSIONS: Breast cancer survival was more than 10 percentage points lower for black females than for white females, and this difference persisted over time. Reducing racial disparities in survival remains a challenge that requires broad, coordinated efforts at the federal, state, and local levels. Monitoring trends in breast cancer survival can highlight populations in need of improved cancer management and treatment. Cancer 2017;123:5100-18. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Original languageEnglish
Pages (from-to)5100-5118
Number of pages19
StatePublished - Dec 15 2017

Bibliographical note

Funding Information:
There is increasing awareness and effort to achieve health equity among racial, ethnic, geographic, socioeconomic, and other groups. With the persistent disparity in breast cancer survival between black females and white females, more national, local, and individual efforts are needed. This study provides accurate, useful information on incidence and survival of breast cancer patients in various US subpopulations and is supported through a nation-wide system of central cancer registries funded by the CDC’s NPCR or the National Cancer Institute’s SEER program.45

Funding Information:
Funding support for Claudia Allemani: US Centers for Disease Control and Prevention (CDC:12FED03123, ACO12036).

Publisher Copyright:
Published 2017. This article is a U.S. Government work and is in the public domain in the USA.


  • breast cancer
  • health disparities
  • population-based survival
  • trends

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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