Ethn Dis 1999 Winter;9(1):111-25
The relationship of socio-economic status and access to minimum expected
therapy among female breast cancer patients in the National Cancer Institute
Black-White Cancer Survival Study.
Breen N, Wesley MN, Merrill RM, Johnson K.
Division of Cancer Control and Population Sciences, National Cancer Institute,
Bethesda, MD 20892-7344, USA. NB19K@NIH.GOV
Black women are more likely to be diagnosed with later stage breast cancer
and have higher mortality rates from breast cancer than white women. To
determine whether cancer treatment varies for white and black women, we
analyzed data from the National Cancer Institute (NCI) Black-White Cancer
Survival Study (BWCSS). Data from hospital medical records, central review
of histology slides, and patient interviews on 861 breast cancer cases
(in situ and invasive) were examined. Minimum expected therapy was defined
for each disease stage as a basic minimum course of treatment that incorporated
current practice, state-of-the-art knowledge, and recommendations advanced
by NIH Consensus Conferences up to and including the one held in 1985.
Patients in this study were diagnosed during 1985-1986. Using logistic
regression techniques, those who received at least the minimum expected
therapy were compared to those who did not. Thirty-six percent of the
patients with late stage disease did not receive minimum expected therapy
compared to four percent of the patients with early stage disease. Older
women and women with no usual source of care were significantly less likely
to receive minimum expected therapy. Overall, 21% of black women did not
receive minimum expected therapy compared to 15% of white women.
PMID: 10355480 [PubMed - indexed for MEDLINE]