Journal article
Patterns of evidence-based care for the diagnosis, staging, and first-line treatment of breast cancer by race-ethnicity: a SEER-Medicare study
Cancer epidemiology, biomarkers & prevention, Vol.32(10), pp.1312-1322
10/01/2023
DOI: 10.1158/1055-9965.EPI-23-0218
PMCID: PMC10592343
PMID: 37436422
Abstract
BACKGROUNDRacial and ethnic disparities in guideline-recommended breast cancer treatment are well documented, however studies including diagnostic and staging procedures necessary to determine treatment indications are lacking. The purpose of this study was to characterize patterns in delivery of evidence-based services for the diagnosis, clinical workup, and first-line treatment of breast cancer by race-ethnicity. METHODSSEER-Medicare data were used to identify women diagnosed with invasive breast cancer between 2000 and 2017 at age 66 or older (n = 215,605). Evidence-based services included diagnostic procedures (diagnostic mammography and breast biopsy), clinical workup (stage and grade determination, lymph node biopsy, and HR and HER2 status determination), and treatment initiation (surgery, radiation, chemotherapy, hormone therapy, and HER2-targeted therapy). Poisson regression was used to estimate rate ratios (RRs) and 95% Confidence Intervals (CIs) for each service. RESULTSBlack and American Indian/Alaska Native (AIAN) women had significantly lower rates of evidence-based care across the continuum from diagnostics through first-line treatment compared to non-Hispanic White (NHW) women. AIAN women had the lowest rates of HER2-targeted therapy and hormone therapy initiation. While Black women also had lower initiation of HER2-targeted therapy than NHW, differences in hormone therapy were not observed. CONCLUSIONSOur findings suggest patterns along the continuum of care from diagnostic procedures to treatment initiation may differ across race-ethnicity groups. IMPACTEfforts to improve delivery of guideline-concordant treatment and mitigate racial-ethnic disparities in healthcare and survival should include procedures performed as part of the diagnosis, clinical workup, and staging processes.
Details
- Title: Subtitle
- Patterns of evidence-based care for the diagnosis, staging, and first-line treatment of breast cancer by race-ethnicity: a SEER-Medicare study
- Creators
- Emma L Herbach - Sylvester Comprehensive Cancer CenterSarah H Nash - University of IowaIngrid M Lizarraga - University of IowaRyan M Carnahan - University of IowaKai Wang - University of IowaAmy C Ogilvie - University of IowaMichaela Curran - University of IowaMary E Charlton - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Cancer epidemiology, biomarkers & prevention, Vol.32(10), pp.1312-1322
- DOI
- 10.1158/1055-9965.EPI-23-0218
- PMID
- 37436422
- PMCID
- PMC10592343
- NLM abbreviation
- Cancer Epidemiol Biomarkers Prev
- eISSN
- 1538-7755
- Grant note
- name: National Cancer Institute, award: P30 CA086862
- Language
- English
- Electronic publication date
- 07/12/2023
- Date published
- 10/01/2023
- Academic Unit
- Epidemiology; Biostatistics; Surgery; Nursing; Center for Social Science Innovation; Injury Prevention Research Center; Community and Behavioral Health
- Record Identifier
- 9984444868502771
Metrics
8 Record Views