21-gene recurrence score testing utilization among older women from different races: A population-based study

Gulbahce, H. Evin; White, Sandra; Herget, Kimberly; Stoddard, Greg; Camp, Nicola J.; Buys, Saundra S.; Sweeney, Carol

doi:10.1016/j.jgo.2020.06.004

Cited by 7 publications

(18 citation statements)

References 33 publications

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“…However, most of them were included the WA and AA patients, and the results showed that AA had a higher rate of high RS (8.3-15.8%) compared to those with WA (5.9-7.1%) [12][13][14]. A recent population-based study has shown no significant difference between race and high RS in BC patients aged ≥65 years [16]. The median age of diagnosis was similar between AA and WA BC patients (58-59 years) [12,13], while Chinese patients were much younger (53 years) in our study.…”

Section: Discussionmentioning

confidence: 97%

Distribution, Chemotherapy Use, and Outcome of the 21-Gene Recurrence Score Between Chinese and White breast Cancer in the United States

Yao

Zhou

et al. 2022

Clinical Breast Cancer

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Section: Discussionmentioning

confidence: 97%

Distribution, Chemotherapy Use, and Outcome of the 21-Gene Recurrence Score Between Chinese and White breast Cancer in the United States

Yao

Zhou

et al. 2022

Clinical Breast Cancer

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“…After screening, 130 articles initially and 59 articles subsequently met the inclusion criteria for this review (Table 1). Most articles were retrospective analyses (n = 52), [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]34,[36][37][38][39][41][42][43][45][46][47][48][49][50]52,[55][56][57][58][59][60][61][62][63][64][66][67][68][69][70][71][73][74][75]…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Among the included studies, 44 focused on racial or ethnic disparities, [17][18][19][22][23][24][25][26][27][28][29][31][32][33][34]38,[41][42][43][44][45][46]49,51,52,[55][56][57][58][60][61][62][63][65][66][67][68][69][70][71][73][74][75]77 followed by 25 on socioeconomic disadvantage, 19,20,27,30,34,37,42,45,…”

Section: Study Characteristicsmentioning

confidence: 99%

“…22,27,28,[31][32][33]36,41,51,[55][56][57][58]62,[65][66][67]71,73,75,77 The primary data source for studies examining racial and/or ethnic disparities in older adults with cancer was the Surveillance Epidemiology and End Results (SEER)-Medicare Database, with 23 of the 44 articles used the SEER database. [17][18][19]22,23,25,26,28,31,32,34,36,[41][42][43]49,53,55,58,62,63,68,74 Most studies examining racial and/or ethnic disparities were influenced by factors on the individual level (n = 41; Figure 4): for example, patients' biological factors, their health behaviors and coping strategies, insurance coverage, and treatment preferences. Twenty-five studies examined racial disparities due to the individual influence of treatments across the healthcare system as the domain of influence (Figure…”

Section: Racial and Ethnic Disparities Among Older Adults With Cancermentioning

confidence: 99%

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A scoping review of racial, ethnic, socioeconomic, and geographic disparities in the outcomes of older adults with cancer

Gilmore,

Grant,

Bethea

et al. 2024

J American Geriatrics Society

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IntroductionCancer health disparities are widespread. Nevertheless, the disparities in outcomes among diverse survivors of cancer ages 65 years and older (“older”) have not been systematically evaluated.MethodsWe conducted a scoping review of original research articles published between January 2016 and September 2023 and indexed in Medline (Ovid), Embase, Scopus, and CINAHL databases. We included studies evaluating racial, ethnic, socioeconomic disadvantaged, geographic, sexual and gender, and/or persons with disabilities disparities in treatment, survivorship, and mortality among older survivors of cancer. We excluded studies with no a priori aims related to a health disparity, review articles, conference proceedings, meeting abstracts, studies with unclear methodologies, and articles in which the disparity group was examined only as an analytic covariate. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis reporting guidelines.ResultsAfter searching and removing duplicates, 2573 unique citations remained and after screening 59 articles met the inclusion criteria. Many investigated more than one health disparity, and most focused on racial and ethnic (n = 44) or socioeconomic (n = 25) disparities; only 10 studies described geographic disparities, and none evaluated disparities in persons with disabilities or due to sexual and gender identity. Research investigating disparities in outcomes among diverse older survivors of cancer is increasing gradually—68% of eligible articles were published between 2020 and 2023. Most studies focused on the treatment phase of care (n = 28) and mortality (n = 26), with 16 examined disparities in survivorship, symptoms, or quality of life. Most research was descriptive and lacked analyses of potential underlying mechanisms contributing to the reported disparities.ConclusionLittle research has evaluated the effect of strategies to reduce health disparities among older patients with cancer. This lack of evidence perpetuates cancer inequities and leaves the cancer care system ill equipped to address the unique needs of the rapidly growing and increasingly diverse older adult cancer population.

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“…Data indicate that older women are both less likely to be tested with the 21-gene recurrence score assay (Oncotype DX; Genomic Health, Redwood City, CA, USA) and are less likely to have a high-risk recurrence score than are younger patients with ER+ cancers. 64 – 66 Furthermore, older patients, when tested, are treated less frequently with adjuvant chemotherapy than are younger patients: only 3·6% of women aged 70 years or older with a recurrence score between 11 and 25 and 38·1% of women aged 70 years or older with a recurrence score of more than 25 receive adjuvant chemotherapy (compared with 8·6% and 74·0%, respectively, of patients aged 50–70 years). 67 Older patients might also not receive as much benefit from adjuvant chemotherapy, even in the high-risk recurrence score group.…”

Section: Clinical Trends In De-implementation In Low-risk Breast Cancer In Older Womenmentioning

confidence: 99%

Personalising therapy for early-stage oestrogen receptor-positive breast cancer in older women

Carleton

Nasrazadani

Gade

et al. 2022

The Lancet Healthy Longevity

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Age is one of the most important risk factors for the development of breast cancer. Nearly a third of all breast cancer cases occur in older women (aged ≥70 years), with most cases being oestrogen receptor-positive (ER+). Such tumours are often indolent and unlikely to be the ultimate cause of death for older women, particularly when considering other comorbidities. This Review focuses on unique clinical considerations for screening, detection, and treatment regimens for older women who develop ER+ breast cancers—specifically, we focus on recent trends for de-implementation of screening, staging, surgery, and adjuvant therapies along the continuum of care. Additionally, we also review emerging basic and translational research that will further uncover the unique underlying biology of these tumours, which develop in the context of systemic age-related inflammation and changing hormone profiles. With prevailing trends of clinical de-implementation, new insights into mechanistic biology might provide an opportunity for precision medicine approaches to treat patients with well tolerated, low-toxicity agents to extend patients’ lives with a higher quality of life, prevent tumour recurrences, and reduce cancer-related burdens.

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21-gene recurrence score testing utilization among older women from different races: A population-based study

Cited by 7 publications

References 33 publications

Distribution, Chemotherapy Use, and Outcome of the 21-Gene Recurrence Score Between Chinese and White breast Cancer in the United States

Distribution, Chemotherapy Use, and Outcome of the 21-Gene Recurrence Score Between Chinese and White breast Cancer in the United States

A scoping review of racial, ethnic, socioeconomic, and geographic disparities in the outcomes of older adults with cancer

Personalising therapy for early-stage oestrogen receptor-positive breast cancer in older women

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