Kelly Hirko

Characterizing Inflammatory Breast Cancer Occurrence among Arab-American women in the California, Detroit and New Jersey Surveillance, Epidemiology and End Results (SEER) Registries

BACKGROUND:
Inflammatory breast cancer (IBC) is characterized by an apparent striking geographical distribution in incidence, being particularly more common in North Africa than other parts of the world. Despite the rapid growth of immigrants to the United States from Arab nations, very little is known about disease patterns among Arab Americans because a racial/ethnic category is often not appropriated for this group.

STUDY OBJECTIVE:
The aim of this study is to estimate the proportion of IBC out of all breast cancers among Arab Americans, African Americans and European Americans in the California, Detroit and New Jersey SEER registries. We chose these registries to maximize the number of Arab Americans in our sample. We believe that there will be a higher proportion of IBC out of all breast cancers in Arab Americans as compared to other racial groups in the Detroit, New Jersey and California.

METHODS:
To characterize IBC occurrence among Arab Americans, a database of Arabic names will be linked with the National Cancer Institute’s SEER registry data from 1988-2008 to identify women of Arab descent. IBC cases will be identified using comprehensive coding including ICD-O 8530, which requires pathologic plugging of the dermal lymphatics with tumor emboli or the extent of disease (EOD) codes EOD-E70 or EOD-E 710-730 or AJCC T4d. We will evaluate differences in the proportion of IBC and tumor characteristics between racial categories using chi-square tests for categorical variables and ANOVA for continuous variables. Further, we will formulate logistic regression models to estimate odds ratios for IBC vs. non-IBC by race accounting for potential confounding factors.

CONCLUSION:
Understanding the descriptive epidemiology of IBC among Arab Americans in the United States may generate hypotheses about potential risk factors for this aggressive disease and increase our understanding of its etiology. This exploratory study is critical for understanding factors that may contribute to IBC risk. This study addresses the need for cancer research among Arab Americans in the United States and also utilizes a novel surname list to identify those of Arabic descent from the SEER registries.

PUBLICATIONS:
Hirko KA, Soliman AS, Banerjee M, Ruterbusch J, Harford JB, Chamberlain RM, Graff JJ, Merajver SD, Schwartz K. Characterizing inflammatory breast cancer among Arab Americans in the California, Detroit and New Jersey Surveillance, Epidemiology and End Results (SEER) registries (1988–2008). Springerplus. 2013 Dec;2(1):3. Epub 2013 Jan 7.

About Kelly
Kelly graduated from the University of Michigan in 2002 with a B.S. degree in Cognitive Science and Organizational Studies. After working in a cancer research laboratory in Boston she decided to pursue a career in Public Health. Kelly earned a MPH degree in Epidemiology from Boston University in 2008 and earned a PhD candidate at the University of Michigan School of Public Health pursuing research on inflammatory breast cancer in 2013.
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