Insurance and socioeconomic status do not explain racial disparities in breast cancer care

October 11, 2010

Racial disparities in the receipt of breast cancer care persist despite accounting for patients' insurance and social and economic status. That is the conclusion of a study published early online in Cancer, a peer-reviewed journal of the American Cancer Society. The findings suggest that greater efforts are needed to better understand disparities in breast cancer care and to ensure that all affected women receive equal and effective treatments.

Studies have demonstrated that black and Hispanic women are less likely to receive recommended breast cancer treatments than white women, but few studies have examined whether these differences in the receipt of breast cancer care are affected by patients' socioeconomic status and health insurance. Rachel Freedman, MD, MPH, of the Dana-Farber Cancer Institute in Boston led a team that examined recommended breast cancer care (including localized therapy, hormone receptor testing, hormonal therapy, and chemotherapy) received by a large national sample of women with breast cancer. The researchers assessed whether insurance and socioeconomic factors were associated with any observed racial/ethnic differences in care.

The study included information from 662,117 white, black, and Hispanic women who were diagnosed with invasive breast cancer from 1998 to 2005 at National Cancer Data Base (NCDB) hospitals. (The NCDB is a registry that collects patient demographics, tumor characteristics, first course of treatment, and outcomes for cancer patients treated at U.S. hospitals.) Most women were white (86 percent), 10 percent were black, and 4 percent were Hispanic. Most had private insurance (51 percent) or Medicare (41 percent).

Compared with white women, black women had 0.91 times lower odds of receiving recommended local therapy, 0.90 times lower odds of receiving hormonal therapy, and 0.87 times lower odds of receiving chemotherapy. Hispanic women were also less likely than white women to receive hormonal therapy. Hormone receptor testing did not differ by race/ethnicity. These modest racial disparities persisted even after accounting for insurance and socioeconomic status.

Despite efforts to eliminate disparities in cancer care in recent years, this study suggests that modest racial differences in the receipt of recommended breast cancer care still persist even after taking patients' insurance and socioeconomic status into account. "Although health insurance expansion may resolve disparities in treatment by health insurance status, this study suggests that expansion alone is unlikely to have a major impact on disparities in breast cancer care among black women," said Dr. Freedman. She noted that multifaceted efforts are needed to ensure that all women with breast cancer receive effective treatments.
-end-


Wiley

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.