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Racial Disparities in Breast Cancer Treatments and Adverse Events in the SEER-Medicare Data
1Rutgers New Jersey Medical School and the Cancer Institute of New Jersey, 185 South Orange Avenue, MSB F671, Newark, NJ 07103, USA.
Cancers
|September 9, 2023
Summary
African American (AA) breast cancer (BC) patients experience shorter survival than white (W) patients, partly due to disparities in adverse events (AEs) across different cancer care venues. Treatment and AE rates vary significantly by patient race and care setting.
Area of Science:
- Oncology
- Health Services Research
- Health Disparities
Background:
- African American (AA) patients exhibit poorer breast cancer (BC) survival rates compared to White (W) patients.
- Factors like screening disparities, delayed presentation, and access to care contribute to survival differences.
- Adverse events (AEs) in cancer treatment may lead to treatment delays, incomplete therapies, earlier recurrence, and reduced survival.
Purpose of the Study:
- To investigate if cancer care venue influences treatment and associated adverse events (AEs) in African American (AA) versus White (W) breast cancer (BC) patients.
- To analyze differences in treatment rates, administered drugs, and AEs based on care venue (Outpatient vs. National Claims History - NCH).
Main Methods:
- Analysis of the SEER-Medicare dataset, comparing Outpatient (hospital/facility) and National Claims History (NCH - physician/office) files.
- Examination of venue-specific differences in treatment rates, drug administration, and AEs between AA and W patients.
- Statistical analysis to assess the impact of care venue on treatment and AE disparities, controlling for comorbidities and age.
Main Results:
- Statistically significant venue-specific differences in treatment rates, drug administration, and AEs were observed between AA and W patients.
- AA patients in NCH settings received lower treatment rates, while those in Outpatient settings received higher rates compared to W patients.
- AE rates per treatment were higher in NCH settings than Outpatient settings. AEs were consistently higher in AA patients than W patients, irrespective of comorbidities or age.
Conclusions:
- Significant disparities in breast cancer (BC) treatment rates and adverse events (AEs) exist between African American (AA) and White (W) patients, influenced by the care venue.
- Differences in the frequency of specific anticancer drugs and their associated AEs contribute to higher AE rates in AA patients.
- Venue-dependent variations in treatment and AEs likely play a role in the observed survival differences between AA and W breast cancer patients.
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