Using FastTrack to implement an academic medical center and community health center collaborative for cancer care delivery

Waldman, Laura Tesler; Bean, W Geinor; Levine, Anne; Cohen-Bearak, Adena; Phelps, Fawn A.; Svoboda, Ludmila; Freedman, Rachel A.; Elfiky, Aymen; Berlin, Suzanne; Abel, Gregory A.; Deutsch, Charles; Lathan, Christopher S.

doi:10.1016/j.hjdsi.2013.09.002

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…Understanding why disparities in mortality exist should remain a priority for future study until all women can experience equal improvements in their outcomes. In an era where we will see increasing use of targeted, costly therapies, assuring access to efficacious treatments will be crucial [44].…”

Section: Discussionmentioning

confidence: 99%

Racial differences in outcomes for patients with metastatic breast cancer by disease subtype

Vaz-Luís

Lin

Keating

et al. 2015

Breast Cancer Res Treat

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Treatment advances have differed by breast cancer subtype. We examined the impact of race on survival of women with metastatic breast cancer by disease subgroup. Using surveillance, epidemiology, and end results -Medicare data, we included white and black patients aged ≥66 with de novo metastatic breast cancer diagnosed between 1998 and 2009. Using trastuzumab as a proxy for human epidermal growth factor receptor 2 (HER2)-positive status, we defined three disease subgroups: (1) HER2-positive (received trastuzumab), (2) HER2-negative/unknown (never received trastuzumab)/hormone receptor (HR)-positive, and (3) HER2-negative/unknown/HR-negative. Multivariate Cox proportional models assessed the impact of race on overall survival (OS) and breast cancer-specific survival by subgroup. We also examined trastuzumab treatment patterns. Among 4364 women (86 % white, 14 % black), 9 % had HER2-positive, 72 % had HER2-negative/unknown/HR-positive, and 18 % had HER2-negative/unknown/HR-negative tumors. Patients with HER2-positive disease experienced longer median OS compared with others: 2.4 versus 1.8 years for women with HER2-negative/unknown/HR-positive and 0.5 years for women with HER2-negative/unknown/HR-negative disease (P < 0.001). Racial differences in OS were only observed among patients with HER2-positive tumors: median OS: 1.4 versus 2.7 years for black and white women, adjusted hazard ratio 1.45; 95 % Confidence interval 1.01-2.08. Results for breast cancer-specific survival were similar. We also observed racial differences in trastuzumab utilization, with longer median time to trastuzumab initiation and lower likelihood of continuation over time for black (vs. white) patients. Among women with de novo metastatic breast cancer, racial differences in survival were only apparent for those with inferred HER2-positive tumors. Further study of how treatment patterns affect outcomes is warranted.

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Section: Discussionmentioning

confidence: 99%

Racial differences in outcomes for patients with metastatic breast cancer by disease subtype

Vaz-Luís

Lin

Keating

et al. 2015

Breast Cancer Res Treat

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“…The main goal of the outreach initiative, as described in a previously published paper on the program's implementation, focused on resolution of the cancer-related clinical issue within 21 days. 65 Secondary outcomes include clinical trial enrollment and self-reported financial distress.…”

Section: Methodsmentioning

confidence: 99%

The Colocation Model in Community Cancer Care: A Description of Patient Clinical and Demographic Attributes and Referral Pathways

Stockman

Gundersen

Gikandi

et al. 2023

JCO Oncology Practice

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PURPOSE Cancer disparities are well documented among Black, Indigenous, and People of Color, yet little is known about the characteristics of programs that serve these populations. Integrating specialized cancer care services within community settings is important for addressing the needs of historically marginalized populations. Our National Cancer Institute–Designated Cancer Center initiated a clinical outreach program incorporating cancer diagnostic services and patient navigation within a Federally Qualified Health Center (FQHC) to expedite evaluation and resolution of potential cancer diagnoses with the goal of collaboration between oncology specialists and primary care providers in a historically marginalized community in Boston, MA. MATERIALS AND METHODS Sociodemographic and clinical characteristics were analyzed from patients who were referred to the program for cancer-related care between January 2012 and July 2018. RESULTS The majority of patients self-identified as Black (non-Hispanic) followed by Hispanic (Black and White). Twenty-two percent of patients had a cancer diagnosis. Treatment and surveillance plans were established for those with and without cancer at a median time to diagnostic resolution of 12 and 28 days, respectively. The majority of patients presented with comorbid health conditions. There was a high prevalence of self-reported financial distress among patients seeking care through this program. CONCLUSION These findings highlight the wide spectrum of cancer care concerns in historically marginalized communities. This review of the program suggests that integrating cancer evaluation services within community-based primary health care settings offers promise for enhancing the coordination and delivery of cancer diagnostic services among historically marginalized populations and could be a method to address clinical access disparities.

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Using FastTrack to implement an academic medical center and community health center collaborative for cancer care delivery

Cited by 2 publications

References 8 publications

Racial differences in outcomes for patients with metastatic breast cancer by disease subtype

Racial differences in outcomes for patients with metastatic breast cancer by disease subtype

The Colocation Model in Community Cancer Care: A Description of Patient Clinical and Demographic Attributes and Referral Pathways

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