Competing Risks Analysis of African American Breast Cancer Patients

Purpose: Recent studies showed that African Americans (AA) breast cancer patients experience lower survival than any other race. The knowledge of cause-specific survival of such patients is necessary to investigate the different factors associated with the disease and support the clinical practice. Methods: The parametric competing risk method is applied to build up the survival models and the parametric mixture model is used to study the overall survival of these patients. The Kaplan-Meier survival estimation is also computed to compare the results. Results: The overall death rate decreases sharply immediately after the diagnosis and increases thereafter. The risk of death from breast cancer itself is the highest at the first five years; other causes, however, pose more threats to patients after this period. The patients who received only surgery have higher survival rate in long run. The use of radiation only does not have the significant effect on patients’ survival. Conclusion: Our study shows that the parametric competing risk models are promising in estimating the cause-specific survival of AA breast cancer patients and can be used for clinical practice. We also observed that heart and other diseases pose more threat to breast cancer patients in the long run.