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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.”

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