Abstract P1-09-20: Evaluating alcohol and tobacco use in an ethnically diverse sample of breast cancer patients: Implications for survivorship
Authors: Bea Vivian J , Cunningham Joan E , Burshell Dana R , Ford Marvella E 
Published: May 2015

Abstract
Background/Objective: Data suggest that modifiable risk factors such as alcohol and tobacco use may increase the risk of breast cancer (BC) recurrence and reduce survival. According to 2012 data from the Centers for Disease Control (CDC) and Prevention Behavioral Risk Factor Surveillance System (BRFSS), 4.8% of women in South Carolina (SC) are heavy drinkers (&gt;1 drink/day) with 9.6% having ≥4 drinks at least once in the past month (US state medians are 5.2% and 11.4%); 19.1% are current smokers (US state median 17.4%). Female BC mortality in SC is almost 50% higher in African Americans (AAs) than in European Americans (EAs; 27.5/100,000 and 19.1%, respectively). In SC, there is an AA subpopulation, the Sea Islanders, who carry the lowest AA rate of European genetic admixture. Given the substantial racial survival disparity we examined the patterns of alcohol and tobacco use in an on-going, ethnically diverse statewide study of women with recently diagnosed breast cancer.
Methods: Participants were identified within 18 months post-diagnosis through the SC Central Cancer Registry (SCCCR). Women who opted into the study were interviewed via telephone, self-reporting data including race/ethnicity, educational status, alcohol consumption and tobacco use during the past 30 days. Published CDC guidelines were used to categorize alcohol and tobacco use.
Results: During the first 24 months of recruitment, 172 women ages 38 to 90 years have opted into our study; 139 were interviewed (43 EAs and 96 AAs) and results analyzed. AAs were slightly younger (p=0.066) and tended to have less education (statistically not significant: p=0.114)
Alcohol: The minority of participants self-identified consuming alcohol (29.0%). Heavy use was infrequent: two (1.4%) reported consuming on average &gt;1 drink/day,and six (4.4%) consumed ≥4 drinks on any day. Alcohol consumption was less prevalent among AAs than EAs (p=0.025). Among those who consumed alcohol, usage did not differ between AAs and EAs.
Tobacco: Smoking (daily or occasional) was reported by 7.5% of participants (AA vs EA: p=1.00).
Alcohol and/or Tobacco: Use of alcohol and/or tobacco was 1.7 times as prevalent among EAs compared to AAs (47.6% vs 28.7%; p=0.032).
Conclusions: Compared to self-reported state data few participants reported heavy alcohol consumption or current tobacco use, particularly AAs, but 34.6% of participants do use alcohol or tobacco. While these findings suggest that alcohol and tobacco may not contribute to the racial disparities in breast cancer mortality observed in SC, it is nonetheless imperative to reduce these modifiable risk factors and improve breast cancer outcomes for all breast cancer survivors, regardless of race and ethnicity.
Table 1 African American (AA) N=96European American (EA) N=43p-valueAge (years): mean (±st dev*)58.8 (±11.6)62.9 (±13.2)0.066Education: more than high school51 (53.1%)29 (67.4%)0.114Alcohol in past 30 daysYes (vs No)22 (23.2%)18 (41.9%)0.025Among those who drink:Heavy: average &gt;1 drink/day1 (4.6%)1 (5.6%)1.000Current tobacco useYes (vs No)7 (7.6%)3 (7.1%)1.000Among smokers: Daily use:4 (57.1%)3 (100%)0.475Alcohol and/or Tobacco27 (28.7%)20 (47.6%)0.032Both Alcohol and Tobacco2 (2.2%)1 (2.4%)1.000*standard deviation
Citation Format: Vivian J Bea, Joan E Cunningham, Dana R Burshell, Marvella E Ford. Evaluating alcohol and tobacco use in an ethnically diverse sample of breast cancer patients: Implications for survivorship [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-09-20.