The researchers led by Grace Li Smith reviewed the Medicare records of more than 37,000 patients diagnosed with early stage breast cancer in 2003. “The comprehensive national Medicare database allowed us to determine the extent to which racial disparities in radiation therapy affected patients across the country”, said Smith.
For the retrospective cohort study, the team used Medicare claims to examine the treatment history of women aged 66 and older diagnosed in 2003 with early stage, newly diagnosed breast cancer. Of the 37,305 women who underwent a lumpectomy for their breast cancer, 34,024 were white and 2,305 were black. Overall, 74 percent of the white women received radiation therapy after their lumpectomy; in contrast, 65 percent of the black breast cancer patients received the same treatment.
“The use of radiation after lumpectomy is considered to be the standard of care for women with invasive breast cancer, as clinical trials have demonstrated that it both reduces the chance of recurrence and improves the chance of survival,” said Thomas Buchholz, the study’s senior author. “While there are some breast cancer patients, such as those over age 70, with significant co-morbidities for whom radiation would not be appropriate, this discrepancy remained consistent when specifically looking at patients under the age of 70.”
An unexpected aspect of the study, said Smith, was the magnitude of the disparity in specific areas of the country: the Pacific West, 72 (whites) versus 55 percent (blacks); East South Central, 72 (whites) versus 57 percent (blacks); and the Northeast, 70 (whites) versus 58 percent (blacks).
However, in some parts of the country - the Mountain West (76 percent versus 74 percent) and the North Central Midwest (74 percent versus 72 percent) - there was virtually no discrepancy in radiation rates between whites and blacks. That level of geographic non-disparity was also surprising, said Smith.
MEDICA.de; Source: University of Texas M. D. Anderson Cancer Center