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Racial disparities in the use of radiotherapy after breast-conserving surgery: A national Medicare study
Cancer, 12/16/2009
Smith GL et al. – In this comprehensive national sample of older breast cancer patients, substantial racial disparities were identified in RT use after BCS across much of the United States. Efforts to improve breast cancer care require overcoming these disparities, which exist on a national scale
Methods- A national Medicare database was used to identify all beneficiaries (age > 65 years) treated with BCS for incident invasive breast cancer in 2003
- Claims codes identified RT use, and Medicare demographic data indicated race
- Logistic regression modeled RT use in white, black, and other-race patients, adjusted for demographic, clinical, and socioeconomic covariates.
- Of 34,080 women, 91% were white, 6% were black, and 3% were another race
- Mean age of patients was 76 ± 7 years
- Approximately 74% of whites, 65% of blacks, and 66% of other-race patients received RT
- After covariate adjustment, whites were found to be significantly more likely to receive RT than blacks (odds ratio, 1.48; 95% confidence interval, 1.34-1.63 )
- Disparities between white and black patients varied by geographic region, with blacks in areas of the northeastern and southern United States demonstrating the lowest rates of RT use (57% in these regions)
- In patients age < 70 years, racial disparities persisted
- Specifically, 83% of whites, 73% of blacks, and 78% of other races in this younger group received RT
