Forest or Trees? The Consequences of Aggregating Data from Diverse Populations

Looking across a whole population can mask important variations in its subgroups.

The concept of “social determinants of health” resonates with more people than ever before. Implicit in the phrase is that not everyone has equal access to healthcare, resulting in different outcomes in different populations. Complicating our understanding of these inequities is a less-than-granular way of looking at distinct populations. This point was highlighted in a recent analysis of rates of invasive second breast cancers (SBCs), either ipsilateral (ii) or contralateral (ic) following a diagnosis of ductal carcinoma in situ (DCIS) in Hawaii.

Investigators used the Hawaii Tumor Registry to identify 6221 women >20 years of age with a diagnosis of DCIS between 1973 and 2017. The population comprised: Japanese, 37%; white, 23%; Filipino, 1…

Reviewing Author

William J. Gradishar, MD

Disclosures

Consultant/Advisory BoardLilly; AstraZeneca; Gilead

Grant/Research SupportBreast Cancer Research Foundation

Editorial BoardsClinical Breast Cancer; Oncology; Annals of Surgery; Breast Cancer Research and Treatment

Leadership Positions in Professional SocietiesNational Comprehensive Cancer Network (Chair, Breast Cancer Panel); American Board of Internal Medicine (Medical Oncology Board)