Racial Differences in the Use of Adjuvant Chemotherapy for Breast Cancer in a Large Urban Integrated Health System. (20th May 2012)

• Record Type: Journal Article
• Authors: Simon, Michael S.; Lamerato, Lois; Krajenta, Richard; Booza, Jason C.; Ruterbusch, Julie J.; Kunz, Sara; Schwartz, Kendra
• Other Names: Han Wonshik Academic Editor.
• Is Part Of: International journal of breast cancer. Volume 2012(2012)
• Publication Date: 2012-05-20
• Subjects: Breast -- Cancer -- Periodicals; Periodicals; Breast Neoplasms; Breast -- Cancer; Periodicals; Periodicals; 616.99449
• DOI: 10.1155/2012/453985
• Languages: English
• ISSNs: 2090-3170

Abstract

Abstract : Background . Racial differences in breast cancer survival may be in part due to variation in patterns of care. To better understand factors influencing survival disparities, we evaluated patterns of receipt of adjuvant chemotherapy among 2, 234 women with invasive, nonmetastatic breast cancer treated at the Henry Ford Health System (HFHS) from 1996 through 2005. Methods . Sociodemographic and clinical information were obtained from linked datasets from the HFHS, Metropolitan Detroit Cancer Surveillance Systems, and U.S. Census. Comorbidity was measured using the Charlson comorbidity index (CCI), and economic deprivation was categorized using a neighborhood deprivation index. Results . African American (AA) women were more likely than whites to have advanced tumors with more aggressive clinical features, to have more comorbidity and to be socioeconomically deprived. While in the unadjusted model, AAs were more likely to receive chemotherapy (odds ratio (OR) 1.22, 95% confidence interval (CI) 1.02–1.46) and to have a delay in receipt of chemotherapy beyond 60 days (OR 1.68, 95% CI, 1.26–1.48), after multivariable adjustment there were no racial differences in receipt (odds ratio (OR) 1.02, 95% confidence interval (CI) 0.73–1.43), or timing of chemotherapy (OR 1.18, 95 CI, 0.8–1.74). Conclusions . Societal factors and not race appear to have an impact on treatment delay among African American women with early breast cancer.