Minority Health Archive

Racial variation in breast cancer treatment among department of defense beneficiaries

Enewold, Lindsey and Zhou, Jing and McGlynn, Katherine A. and Anderson, William F. and Shriver, Craig D. and Potter, John F. and Zahm, Shelia H. and Zhu, Kangmin (2011) Racial variation in breast cancer treatment among department of defense beneficiaries. Cancer. n/a. ISSN 0008543X

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BACKGROUND: Although the overall age-adjusted incidence rates for female breast cancer are higher among whites than blacks, mortality rates are higher among blacks. Many attribute this discrepancy to disparities in health care access and to blacks presenting with later stage disease. Within the Department of Defense (DoD) Military Health System, all beneficiaries have equal access to health care. The aim of this study was to determine whether female breast cancer treatment varied between white and black patients in the DoD system. METHODS: The study data were drawn from the DoD cancer registry and medical claims databases. Study subjects included 2308 white and 391 black women diagnosed with breast cancer between 1998 and 2000. Multivariate logistic regression analyses that controlled for demographic factors, tumor characteristics, and comorbidities were used to assess racial differences in the receipt of surgery, chemotherapy, and hormonal therapy. RESULTS: There was no significant difference in surgery type, particularly when mastectomy was compared with breast-conserving surgery plus radiation (blacks vs whites: odds ratio [OR], 1.1; 95% confidence interval [CI], 0.8-1.5). Among those with local stage tumors, blacks were as likely as whites to receive chemotherapy (OR, 1.2; 95% CI, 0.9-1.7) and hormonal therapy (OR, 1.0; 95% CI, 0.6-1.4). Among those with regional stage tumors, blacks were significantly less likely than whites to receive chemotherapy (OR, 0.4; 95% CI, 0.2-0.7) and hormonal therapy (OR, 0.5; 95% CI, 0.3-0.8). CONCLUSIONS: Even within an equal access health care system, stage-related racial variations in breast cancer treatment are evident. Studies that identify driving factors behind these within-stage racial disparities are warranted. Cancer 2011;. © 2011 American Cancer Society.

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Item Type: Article
Additional Information: This article is available at the publisher’s Web site. Access to the full text is subject to the publisher’s access restrictions.
Uncontrolled Keywords: breast cancer, mortality rates, disparities, Department of Defense (DoD) Military Health System, health care access
Subjects: Health > Health Equity > Access To Healthcare
Health > Disparities
Health > Public Health > Chronic Illness & Diseases > Cancer
Research > studies
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Depositing User: Users 141 not found.
Date Deposited: 30 Jul 2011 15:46
Last Modified: 30 Jul 2011 15:46
Link to this item (URI): http://health-equity.lib.umd.edu/id/eprint/2929

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