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

Oct 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 are less likely to receive recommended 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 . 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 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 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.

Explore further: Spicy treatment the answer to aggressive cancer?

Related Stories

Racial disparities persist in cancer care

Jan 07, 2008

A new study finds that, despite efforts in the last decade to mitigate cancer treatment disparities, black patients are significantly less likely than white patients to receive therapy for various types of cancer. The authors ...

Breast cancer risk factors differ among races

Apr 26, 2010

A new study finds that factors known to increase the risk of breast cancer among white women have less influence in Hispanic women. Published early online in Cancer, a peer-reviewed journal of the American Cancer Societ ...

Recommended for you

Spicy treatment the answer to aggressive cancer?

11 hours ago

It has been treasured by food lovers for thousands of years for its rich golden colour, peppery flavour and mustardy aroma…and now turmeric may also have a role in fighting cancer.

Cancer survivors who smoke perceive less risk from tobacco

Jul 02, 2015

Cancer survivors who smoke report fewer negative opinions about smoking, have more barriers to quitting, and are around other smokers more often than survivors who had quit before or after their diagnosis, according to a ...

Melanoma mutation rewires cell metabolism

Jul 02, 2015

A mutation found in most melanomas rewires cancer cells' metabolism, making them dependent on a ketogenesis enzyme, researchers at Winship Cancer Institute of Emory University have discovered.

User comments : 1

Adjust slider to filter visible comments by rank

Display comments: newest first

mysticshakra
not rated yet Oct 11, 2010
Perhaps its because whites are more easily swayed by medical voodoo? Poison therapy and breast amputation aren't as socially acceptable to non whites is my guess.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.