Prevalence of breast cancer across racial, socioeconomic, and regional groups in the US: Analysis of comorbidity distributions using the National Inpatient Sample Database in 2019-2020.

Abstract

e13161 Background: Despite advancements in breast cancer screening, it remains the most common cancer among women after skin cancer and the second leading cause of cancer-related deaths. Several modifiable and non-modifiable risk factors have been identified, including race, obesity, reproductive factors, family history, and radiation exposure. This study analyzes breast cancer hospitalization prevalence across racial, socioeconomic, and regional groups in the U.S., along with comorbidity distribution. Methods: Using the Nationwide Inpatient Sample (NIS) database, female patients with a primary breast cancer diagnosis discharged in 2019–2020 were categorized into two racial groups (ICD-10 codes). STATA was used to analyze breast cancer prevalence, hospital length of stay, charges, and comorbidities. Results: A total of 63,225 female patients (mean age: 59 years) were included. Non-Hispanic White females made up 60.1% of the population. Mortality rates showed no significant difference (2.88% vs. 3.13%, p = 0.4902). Mean hospital charges were $82,438 vs. $88,965 (p = 0.0002), and the length of stay was 3.2 vs. 3.75 days (p < 0.001). The highest regional prevalence was observed in the South (p < 0.001). Among Non-Hispanic White females, the highest breast cancer prevalence was in the highest income group (34.67%, 76th–100th percentile), while among other races, prevalence was highest in the lowest income group (32.76%, 1st–25th percentile, p < 0.001). Conclusions: Breast cancer remains most prevalent among Non-Hispanic White females and imposes a significant financial burden, with average hospitalization costs exceeding $80,000. Regional prevalence differences may reflect education and awareness levels, as screening is more common in the Western U.S. and less in the South. Additionally, higher prevalence among Non-Hispanic White females in the highest socioeconomic group may be linked to better healthcare access, increased screening, and earlier diagnosis. Demographics and characteristics of female breast cancer patients. Variable Non-Hispanic White Females Females of Other Races p-value Total Population 60.1% (37,990) 39.9% (25,235) - Mean Age (years) 60.52 56.78 <0.001 In-Hospital Mortality Rate (%) 2.88% 3.13% 0.4902 Mean Hospital Charges ($) $82,438 $88,965 0.0002 Mean Length of Stay (days) 3.2 3.75 <0.001 Receptor Positivity (ER, PR, HER2) 31.08% 25.99% <0.001 Regional Prevalence (%): <0.001 - Northeast 28.87% 27.67% - Midwest 19.89% 11.46% - South 33.68% 37.22% - West 17.55% 23.65% Income Prevalence (%): <0.001 - Highest Income (76–100%) 34.67% 22.81% - Lowest Income (1–25%) 16.12% 32.76% Comorbidities (%): - COPD 6.07% 3.29% <0.001 - Obesity 14.5 % 16.83% 0.0007 - Smoking History 69.59% 30.41% <0.001 - CHF 5.39% 5.37% 0.9566 - CKD 5.72% 6.12% 0.3546 - Cirrhosis 0.88% 0.73% 0.3750