Franco
EL.
Mechanistic reasoning in sociobehavioral epidemiology: the influence
of race and ethnicity on cancer survival.
Epidemiology 1996;7(3):326-7.
“The difficulty in unveiling the mechanisms for the prognostic
effect of race in different cancers stems from their very complexity…First,
race may influence the patient’s delay in seeking medical attention
and, hence, disease stage, a key prognostic factor. Second, the choice
of initial course of curative or palliative therapy may also be influenced
by the patient’s race in addition to other clinical criteria—albeit
obviously to the oncologic team….Fifth, and also in analogy with
the second mechanism above, race may also affect the choice of treatment
after disease recurrence, which in turn may affect the length of the postrecurrence
survival rate.”