Racialized economic segregation and inequities in treatment initiation and survival among patients with metastatic breast cancer
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View abstract on PubMed
Summary
This summary is machine-generated.Racialized economic segregation is linked to worse breast cancer outcomes. Patients in less privileged areas face delayed treatment and shorter survival, highlighting structural racism
Area Of Science
- Oncology
- Health Equity
- Social Determinants of Health
Background
- Structural racism, specifically racialized economic segregation, contributes to health disparities.
- Persistent inequities exist among patients with breast cancer, particularly in metastatic breast cancer (mBC).
Purpose Of The Study
- To investigate the association between a composite area-level index of racialized economic segregation and real-world treatment and survival outcomes.
- To examine disparities in time to treatment initiation (TTI) and overall survival (OS) for metastatic breast cancer patients based on socioeconomic factors.
Main Methods
- Retrospective cohort study of 27,459 adult women with mBC using a US nationwide electronic health record database (2011-2022).
- Area-level index of concentration at the extremes calculated using census tract data to define socioeconomic strata.
- Kaplan-Meier methods and multivariable-adjusted hazard ratios (HR) used to assess inequities in TTI and OS, controlling for clinical factors.
Main Results
- Patients from least privileged areas were disproportionately Black or Latinx and more likely to be diagnosed with de novo mBC.
- Longer median TTI (38 vs 31 days) and shorter median OS (29.7 vs 39.2 months) were observed in least privileged areas compared to most privileged areas.
- Multivariable analysis showed less timely treatment initiation (HR 0.87) and worse OS (HR 1.19) in least privileged areas.
Conclusions
- Racialized economic segregation is a significant social determinant of health impacting mBC treatment and survival.
- Structural racism, manifested as economic segregation, drives disparities in cancer care.
- Targeted public investments addressing racialized economic segregation are crucial for reducing inequities in breast cancer outcomes.
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