Black women less likely to receive locoregional, hormone therapy for breast cancer

Freedman RA. Cancer. 2010;doi:10.1002/cncr.25542.

Issue: November 10, 2010

Results from an assessment of records collected in the National Cancer Data Base showed that black women with breast cancer were less likely to receive definitive locoregional and hormone therapy compared with white women with similar disease characteristics.

Researchers also said black and Hispanic women were more likely than whites to receive chemotherapy. The results also showed that insurance and socioeconomic status did not explain the disparity.

“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,” Rachel A. Freedman, MD, MPH, a medical oncologist with the Dana-Farber Cancer Institute and a researcher on the study, said in a press release.

There were 662,117 women included in the study; 86% were white, 10% were black and 4% were Hispanic. Black and Hispanic women with cancer tended to be younger, less likely to be uninsured or were insured by Medicaid and had more advanced disease at presentation. These women were also more likely to live in areas with lower high school graduation rates and lower median incomes, and have poorly differentiated, larger and ER-negative tumors.

White women were 0.91 times more likely to receive locoregional therapy compared with black women and 0.9 times more likely to receive adjuvant hormonal therapy. Black and Hispanic women were 0.87 times more likely to receive adjuvant chemotherapy (see table).

Freedman and colleagues said racial/ethnic differences persisted regardless of insurance coverage. For instance, 76.4% of black women with private insurance received definitive locoregional therapy compared with white women who were uninsured (77.7%) or insured by Medicaid (80.4%).