Missed Opportunities: Racial Disparities in Adjuvant Breast Cancer Treatment

Bickell, Nina A.; Wang, Jason; Oluwole, Soji F.; Schrag, Deborah; Godfrey, Henry P.; Hiotis, Karen; Mendez, Jane; Guth, Amber

doi:10.1200/jco.2005.04.5799

Cited by 337 publications

(284 citation statements)

References 28 publications

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“…34 Several studies have revealed disparities because of race/ethnicity, older age, and geographic location in breast cancer care, including the receipt of RT after BCS. 12,13,27,[35][36][37][38][39][40][41][42][43] The present study, however, is the first to document a disparity in the receipt of RT because of race/ethnicity and SES in a single region within the state of California, and an age disparity throughout the entire state. LA, the most populous of the California regions with the largest number and highest percentage of African American and Hispanic residents in this study, is the only region where the association of RT after BCS varied by race/ethnicity.…”

Section: Discussionmentioning

confidence: 90%

“…6,7 Racial and geographic disparities in breast cancer outcomes have been well documented, 3,[8][9][10][11][12] and minority women with early stage breast cancer have been reported to have double the risk for failing to receive necessary adjuvant treatments when compared with white women. 13 We have been investigating breast cancer in California with particular emphasis on subtypes, age, and race/ethnicity. [14][15][16][17] In 2009, we presented preliminary results indicating that there were differences in the use of RT after BCS in the 8 regions of California defined by the California Cancer Registry.…”

Section: Introductionmentioning

confidence: 99%

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Disparities in receipt of adjuvant radiation therapy after breast‐conserving surgery among the cancer‐reporting regions of California

Parise

Bauer

Caggiano

2011

Cancer

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BACKGROUND: Incidence and mortality of breast cancer vary according to demographic factors such as age, race/ ethnicity, socioeconomic status (SES), and geographic region. This study assesses the variation of these factors in the use of adjuvant radiation therapy (RT) after breast-conserving surgery (BCS) among 8 regions of California. METHODS: The authors identified 85,574 cases of first primary female invasive breast cancer with complete data diagnosed between January 1, 2000 and December 31, 2007. Logistic regression was used to determine the association between race/ethnicity, age, SES, and receipt of RT after BCS within each of the regions of California. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed. RESULTS: Age was a significant predictor of receipt of RT after BCS in all regions. In Los Angeles (LA), lower SES was associated with decreasing odds of RT. Racial disparities were evident only in LA, where black (OR, 0.85; 95% CI, 0.74-0.97) and Hispanic (OR, 0.86; 95% CI, 0.78-0.96) women were about 15% less likely to receive RT than white women. CONCLUSIONS: Racial disparities in the receipt of RT after BCS exist only in LA, where African American and Hispanic women are less likely to receive this form of adjuvant treatment. Lower SES was also associated with a reduced likelihood of receipt of RT in LA. Women age 70 years and older are less likely to receive RT after BCS in all regions of California.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Disparities in receipt of adjuvant radiation therapy after breast‐conserving surgery among the cancer‐reporting regions of California

Parise

Bauer

Caggiano

2011

Cancer

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“…15,16 Differences in treatment according to race have been noted in adult diseases such as breast cancer, coronary heart disease, hypertension and schizophrenia. [17][18][19][20] We postulated that differences in delivery patterns for breech presentation may also exist by race, thereby contributing to racial disparities in neonatal outcome.…”

Section: Introductionmentioning

confidence: 99%

Delivery mode by race for breech presentation in the US

2007

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Objective: To determine if there are differential cesarean delivery rates by race and other socio-demographic factors for women with breech infants.Study Design: We calculated cesarean delivery rates for 186 727 White, African American, Hispanic and Asian women delivering breech singletons with gestational age 26 to 41 weeks born in 1999 and 2000 using data from the National Center for Health Statistics. Multivariable logistic regression was used to determine differences in mode of delivery by race, adjusting for socio-demographic and medical factors.Results: Cesarean rates for breech were >80% in most gestational age groups. In 14 of 18 groups, Whites had higher cesarean delivery rates than African Americans. However, this finding did not persist after risk adjustment. Hispanics were more likely to deliver by cesarean delivery than African Americans and Whites.Conclusion: Breech singleton infants are predominantly born by cesarean delivery. Although African-American women with breech presentation have lower cesarean delivery rates than Whites, this difference is not present after adjusting for socio-demographic and medical factors. Hispanics were more likely to be delivered by cesarean delivery and this difference was amplified after risk adjustment. Asians had slightly lower cesarean rates after risk adjustment, but this varied widely according to Asian subgroup.

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“…A landmark study by Elmore et al (2005) revealed racial differences among AA women along the illness trajectory, including timeliness and identification of their first symptoms, diagnosis, and subsequent treatment. AA women are less likely to receive radiation therapy following breast-conserving surgery (Bickell et al, 2006). Even with equal access health care systems such as Medicare, there appears to be a difference in the treatment of breast cancer among AA women (Smith et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

The Meaning of Survivorship as Defined by African American Breast Cancer Survivors

et al. 2014

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Background: While there is an abundance of cancer survivorship research among various racial/ethnic groups, there is a paucity of research on survivors of African descent. To date, the meaning of survivorship has not been reported exclusively among African American breast cancer survivors (AABCS). Purpose: The purpose was to describe and understand the meaning of survivorship among community-dwelling AABCS, mostly recruited from breast cancer support groups. Method: Using a qualitative descriptive approach, an open-ended questionnaire explored the meaning of survivorship among 155 AABCS. An analysis of the content was performed. Results: Among AABCS, survivorship meant having a strong spiritual base, thriving, being resilient, and being altruistic. The survivors self-identified with and embraced the term survivor. Conclusions: These results provide an important understanding of the perspectives and meaning of survivorship among AABCS and may assist in developing cancer survivorship care plans that are relevant, responsive, patient centered, and culturally appropriate.

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Missed Opportunities: Racial Disparities in Adjuvant Breast Cancer Treatment

Cited by 337 publications

References 28 publications

Disparities in receipt of adjuvant radiation therapy after breast‐conserving surgery among the cancer‐reporting regions of California

Disparities in receipt of adjuvant radiation therapy after breast‐conserving surgery among the cancer‐reporting regions of California

Delivery mode by race for breech presentation in the US

The Meaning of Survivorship as Defined by African American Breast Cancer Survivors

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