Int J Med Sci 2008; 5(4):181-188. doi:10.7150/ijms.5.181 This issue Cite
Research Paper
1. Division of Gastroenterology, Case Western Reserve University, Cleveland, OH, USA.
2. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
3. Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
4. Division of Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, USA.
5. Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA.
Objectives: Breast cancer mortality is higher among African Americans than for Whites, though their breast cancer incidence is lower. This study examines whether this disparity may be due to differential receipt of treatment defined as “standard of care” or “addition to standard of care” by the National Comprehensive Cancer Network (NCCN).
Design: Incident, female breast cancer cases, 2,203 African American and 7,518 White, diagnosed during 1996-2002 were identified from the Alabama Statewide Cancer Registry. Breast cancer treatment was characterized as whether or not a woman received standard of care as defined by the NCCN. For cases characterized as receiving standard of care, addition to standard of care was also evaluated, defined as receiving at least one additional treatment modality according to NCCN guidelines. Logistic models were used to evaluate racial differences in standard and addition to standard of care and to adjust for age, stage at diagnosis, year of diagnosis and area of residence.
Results: No racial differences were found for standard (Prevalence Ratio (PR)=1.00) or for addition to standard of care (PR=1.00) after adjustment for confounders. When the adjusted models were examined separately by age, stage, and area of residence, overall no racial differences were found.
Conclusion: No racial differences in standard of care and addition to standard of care for breast cancer treatment were found. Therefore, both African Americans and Whites received comparable treatment according to NCCN guidelines.
Keywords: Breast Neoplasms, Therapeutics, standard of care, racial disparities, cancer registry