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Differences in the quality of breast cancer care among vulnerable populations
- Source :
- Cancer. 104:2347-2358
- Publication Year :
- 2005
- Publisher :
- Wiley, 2005.
-
Abstract
- BACKGROUND It is unknown whether differences in the quality of breast cancer care among women from racial and ethnic minority groups, the elderly, and rural areas have changed over time across the continuum of care. METHODS The linked Surveillance, Epidemiology, and End Results-Medicare database identified 22,701 women ages 66–79 years diagnosed with early stage breast cancer from 1992–1999. Multiple breast cancer processes of care were measured, including breast-conserving surgery, radiation therapy, documentation of estrogen receptor status, surveillance mammography, and a combined measure of “adequate care”. RESULTS African-American and Hispanic women were significantly less likely to receive adequate care than White women in unadjusted comparisons (54.7% and 58.0% vs. 68.4% for African-American and Hispanic vs. White women) and adjusted comparisons (adjusted odds ratio [AOR] 0.67; 95% confidence interval [95% CI] 0.59–0.76, and AOR 0.77; 95% CI 0.66–0.90 for African-American and Hispanic women, respectively). The proportion of Asian/Pacific Islander women receiving adequate care was similar to White women. When considering only women diagnosed with breast cancer from 1997–1999, African-American women remained less likely than White women to receive adequate care (AOR 0.63; 95% CI 0.50–0.79). Women ages 75–79 years were less likely to receive adequate care compared with women ages 66–69 years (AOR 0.74; 95% CI 0.69–0.80), and women from rural (vs. metropolitan) areas were less likely to receive adequate care (AOR 0.81; 95% CI 0.73–0.89). CONCLUSIONS The quality of breast cancer care is lower among vulnerable populations across the continuum of care, and many of these differences have not improved in more recent years. Cancer 2005. © 2005 American Cancer Society.
- Subjects :
- Gerontology
Cancer Research
medicine.medical_specialty
Databases, Factual
Breast Neoplasms
Comorbidity
Ethnic origin
Medicare
Breast cancer
Epidemiology
Ethnicity
medicine
Humans
Estrogen Receptor Status
Mastectomy
Minority Groups
Aged
Neoplasm Staging
Quality of Health Care
business.industry
Racial Groups
Cancer
Odds ratio
medicine.disease
United States
Oncology
Pacific islanders
Female
business
Demography
Subjects
Details
- ISSN :
- 10970142 and 0008543X
- Volume :
- 104
- Database :
- OpenAIRE
- Journal :
- Cancer
- Accession number :
- edsair.doi.dedup.....c26f87fc6e9ba6eeae85bc8f8095fd50
- Full Text :
- https://doi.org/10.1002/cncr.21443