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Minority women more likely to present with higher-grade breast cancer tumors
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Black and Hispanic women are more likely to present with high-grade breast cancer tumors and less likely to receive post-surgical radiation therapy than white women, according to study results presented at the Fifth AACR Conference on The Science of Cancer Health Disparities.
“We also found that patients who got chemotherapy were less likely to get radiation when they needed it,” Abigail Silva, MPH, Susan G. Komen Cancer Disparities Research trainee at the University of Illinois in Chicago, said in a press release. “Because minorities tended to have more aggressive breast cancer that more often required chemotherapy, this disproportionately affected them.”
Silva and colleagues suggested that black and Hispanic women may be less likely than white women who receive post-surgical radiation treatment that adheres to guidelines. The aim of the study was to investigate these disparities and identify factors that explain them.
Researchers analyzed interview and medical record data from 989 breast cancer patients. The study included 397 non-Hispanic white women, 411 non-Hispanic black women and 181 Hispanic women. Eligible participants had been diagnosed between 2005 and 2008.
There were 614 patients with single invasive primary tumors, of whom 443 were eligible for radiation according to National Comprehensive Cancer Network guidelines. Radiation was recommended to 88% of these eligible patients. Ninety-three percent of these eligible patients accepted radiation therapy, and 97% of those who accepted radiation therapy actually received it. This translated into an overall treatment initiation rate of 79%.
Black and Hispanic patients were less likely than whites to initiate radiation (0.75 vs. 0.85).
“We found that once a treatment recommendation was made, the vast majority of patients received treatment,” Silva said. “In addition, greater diffusion of gene expression profiling may improve cancer care, not only by reducing overuse of chemotherapy but by eliminating chemotherapy as a potential barrier to receipt of radiation.”
Moderate- to high-grade tumors and symptomatically detected tumors were more frequently observed in ethnic minorities than whites, and these tumors were less likely to receive radiation (all P values <.01). Chemotherapy was less likely in whites than minorities (P<.0001), which was also linked to lower radiation rates (P<.05). Together, these factors explained 46% of the disparity (P=.002), the researchers wrote.
For more information:
Silva A. Presented at: The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Oct. 27-30, 2012; San Diego.