Reliability of self-reported reproductive factors and childhood social class indicators in a case-control study in women.

PURPOSE: Reproductive factors are often evaluated in epidemiologic interview studies as risk factors for diseases in women. Similarly, childhood social class has been implicated in the etiology of several diseases. Nevertheless, questions related to these factors have not been thoroughly evaluated for test-retest reliability. This research measured the test-retest reliability of reproductive and childhood social class variables, and determined whether reliability differed by case-control status, age, educational level, time between interviews, and interviewer-rated quality of the interview. METHODS: Subjects were participants in a population-based case-control in-person interview study of Hodgkin's disease in northern California women. Twenty-four cases and 22 controls were reinterviewed by telephone between 1992 and 1995, with an average interval of 8 months between interviews. Reliability was assessed using kappa or intraclass correlation coefficients; mean reliability coefficients and 95% confidence intervals (CIs) were estimated using the bootstrap method. RESULTS: Reliability was excellent for all variables (reliability coefficients between 0.76 and 0.96) and did not differ by case-control status (mean reliability = 0.82 for cases and 0.84 for controls), age (mean reliability = 0.85 for age < 40 and 0.82 for age > or = 40), time between interviews (mean reliability = 0.75 for 0-5 months, 0.88 for 6-11 months, and 0.87 for 1 year or more), or interviewer-rated quality of the validity of the original responses (mean reliability = 0.93 for "not too confident" and 0.83 for "confident"). However, reliability was consistently lower among less educated women (mean reliability = 0.56 for high school or less and 0.88 for more than high school), a finding consistent with results of prior studies. CONCLUSIONS: These results indicate that questions about reproductive experience and childhood social class posed in in-person interviews can be answered reliably. However, inclusion of subjects at lower socioeconomic status may result in lower reliability for some interview responses.

Breast cancer characteristics of Vietnamese women in the Greater San Francisco Bay Area.

OBJECTIVES: To examine breast cancer characteristics of women of Vietnamese ancestry living in the San Francisco Bay Area in comparison with those of other racial or ethnic groups in the same area. DESIGN: Data were obtained from the population-based Greater Bay Area Cancer Registry, part of the Surveillance, Epidemiology, and End Results program. We included breast cancer cases diagnosed from 1988 to 1999 and compared the age at diagnosis, stage and histologic grade at diagnosis, estrogen- and progesterone-receptor status, and surgery types across racial or ethnic groups. We also modeled the effect of patient and clinical characteristics and hospital and physician on the racial or ethnic variations in surgery type. RESULTS: Vietnamese women were younger at diagnosis than other racial or ethnic subgroups (mean age, 51.0 years), with 49.6% of the diagnoses occurring in patients younger than 50. They were also significantly more likely to have received mastectomy for their in situ and localized tumors (61.1% having mastectomy) than women of other racial or ethnic groups. The increased likelihood of having mastectomy among Vietnamese women was not affected greatly by age, year of diagnosis, tumor stage, histologic grade, or physician, but was partly attributable to the hospital of diagnosis. CONCLUSIONS: The effects of a lower mean age at diagnosis and the reasons for an unexpectedly higher percentage of mastectomies in this Asian subgroup should be further explored.

Survival differences among Asian subpopulations in the United States after prostate, colorectal, breast, and cervical carcinomas.

BACKGROUND: Information is limited for Asian subgroups regarding survival after diagnosis of the common cancers amenable to routine screening. The authors examined survival after carcinomas of the prostate, colon/rectum, breast, and cervix separately for Chinese, Japanese, Filipinos, and non-Hispanic whites in the United States. METHODS: Using data from the Surveillance, Epidemiology, and End Results program, the authors compared the distributions of stage at diagnosis and computed 5-year cause specific survival probabilities, overall and by stage of disease, for cancer patients whose diagnosis was in 1988-1994 and who were observed through 1997. RESULTS: Among males, Filipinos were more likely to be diagnosed with advanced stage colorectal and prostate carcinomas than other Asians and non-Hispanic whites; they also experienced worse survival after these cancers. This survival deficit occurred across all stages of colorectal carcinoma and remained apparent within distant stage prostate carcinoma. Among females, Chinese were less likely to receive diagnoses of early stage colorectal carcinoma than Japanese and Filipinas. In addition, their survival was consistently lower across more advanced stages of disease. Chinese also experienced somewhat worse survival after diagnosis of early stage cervical carcinoma. Japanese were more likely to be diagnosed with early stage carcinomas but also tended to experience better survival after prostate, colorectal, and breast carcinomas regardless of stage. CONCLUSIONS: Chinese, Japanese, and Filipinos experienced unequal survival after these screenable carcinomas, indicating that certain groups may benefit from more aggressive screening efforts. The heterogeneity of cancer outcomes observed within the community classified as Asian reinforces the need for cancer statistics to be reported for disaggregated subgroups.