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April 5, 1995

Racial Differences in Survival From Breast Cancer-Reply

Author Affiliations

Emory University School of Public Health Atlanta, Ga

JAMA. 1995;273(13):1000. doi:10.1001/jama.1995.03520370040032

In Reply.  —We thank Dr Joslyn for her comments. There is an important difference between African-American women and white women regarding the incidence of breast cancer; the incidence rate of breast cancer is higher among black women before 45 years of age, and greater for white women after 45 years.1 Since breast cancer in premenopausal women has been noted to be associated with poorer survival, the increased incidence of breast cancer among African-American women may be a partial explanation for the poorer survival experience among that group.Age of diagnosis was a design variable in our study; we frequency-matched by age group (<50, 50 to 64, and ≥65 years) and, therefore, ensured approximately equal numbers of African-American and white women in each group. Joslyn is correct in stating that we cannot, therefore, assess the contribution of age to the overall difference in survival between African-American and white women. However,

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