Navigation Links
Insurance, Income Don't Explain 'Race Gap' in Breast Cancer Care

By Kathleen Doheny
HealthDay Reporter

TUESDAY, Oct. 12 (HealthDay News) -- The so-called racial gap in breast cancer care has long been known by researchers, with black and Hispanic women less likely to get recommended breast cancer treatments than white patients.

"Less well known is what the issue is -- is it race itself or something else contributing?" said Dr. Rachel Freedman, a medical oncologist at Dana Farber Cancer Institute in Boston, and an instructor in medicine at Harvard Medical School.

Her team's new study suggests that financial factors such as economic and social class or access to insurance alone can't explain the "gap": Even after accounting for those differences, racial disparities in breast cancer care still showed up.

The study, published online Oct. 11 in the journal Cancer, "was unique because it included adult women of all ages, and included [those with] insurance," Freedman said.

Freedman evaluated information on more than 662,000 white, black and Hispanic women diagnosed with invasive breast cancer from 1998 to 2005. She used data from the U.S. National Cancer Data Base, a registry that collects information on patients' treatments, outcomes, insurance and socioeconomic status.

In the database, 86 percent of the women were white, 10 percent black, and 4 percent Hispanic.

When they evaluated whether women got the correct treatments and testing, the team found no differences by race/ethnicity for hormone receptor testing (evaluating whether a cancer is estrogen-receptor positive or negative, which could help guide treatment).

But they did find differences in other interventions. For example, black women had lower odds of getting recommended treatments -- interventions such as mastectomy or breast-conserving therapy, chemotherapy and hormone therapy (such as aromatase inhibitor drugs to reduce recurrence risk), Freedman said. And Hispanic women were less likely than white women to get hormonal therapy.

Freedman found black women 9 percent less likely than white women to get mastectomy, breast-conserving surgery or other treatments, 10 percent less likely to get hormonal therapy and 13 percent less likely to get chemotherapy.

Importantly, these disparities persisted even after the researchers accounted for insurance coverage and socioeconomic status. "In this study, even with those with the same insurance, there were race gaps," Freedman said.

"Further investigation is needed," she said, "to figure out which [other] factors are meaningful."

Freedman said the study does have limitations, including her finding of relatively modest absolute differences in the care different types of patients received. Even so, because breast cancer is so often diagnosed, these small discrepancies would end up affecting large numbers of women, she said.

While the database was large, the information was not always complete. Information was missing on many women. For instance, more than 46,000 women were excluded from the chemotherapy analysis, because data was missing.

One expert agreed that a gap in care linked to race does seem to persist.

Despite the study's limitations, "it does look like there still are racial differences, but tempered somewhat by insurance and socioeconomic status," said Dr. Nina Bickell, associate professor of healthy policy and medicine, Mount Sinai School of Medicine in New York City.

But for women of any race diagnosed with breast cancer, the message is the same, said Bickell. "I would tell anybody they should be getting information, and there's lots of excellent information available to those with breast cancer."

"Get it from credible sources," she said, such as the American Cancer Society.

She also recommends that women diagnosed with breast cancer write a list of questions before they go in for a doctor visit, take a friend or family member with them to help them understand options, and consider taking a tape recorder so information can be replayed later.

More information

To find out more about race-linked discrepancies in cancer care, head to

SOURCES: Rachel A. Freedman, M.D., M.P.H., medical oncologist, Dana Farber Cancer Institute, Boston; Nina Bickell, M.D., M.P.H., associate professor, health policy and medicine, Mount Sinai School of Medicine, New York City; Oct. 11, 2010, Cancer, online

Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Midlife crisis: Unmarried older women twice as likely to lack health insurance, study shows
2. Labiaplasty May Be Covered by Insurance, Notes Chicago-area Plastic Surgeon Allan Parungao, MD
3. Uninsured more likely to die from trauma than patients with insurance, study finds
4. Insurance, Race and Poverty Affect Cancer Care, Researchers Report
5. Obese workers cost workplace more than insurance, absenteeism
6. PA Breast Cancer Coalition Launches Income Tax Refund Campaign
7. Guardian Brings Income Protection to New Level with Student Loan Protection Program
8. Universal Health Realty Income Trust Reports 2009 Fourth Quarter and Full Year Financial Results
9. Unilens Vision Reports Record Second Quarter Earnings And Royalty Income
10. K-State Study Finds Abundance of Food Stores, Not Lack of Them, Puts Low-Income Women In Small Cities at Higher Risk of Obesity
11. Study: Kidney disease a big risk for younger, low-income minorities
Post Your Comments:
Related Image:
Insurance, Income Don't Explain 'Race Gap' in Breast Cancer Care
(Date:11/27/2015)... ... November 27, 2015 , ... Lizzie’s Lice Pickers just announced a ... customers 10% off of their purchase of lice treatment product. In addition, customers will ... to a company spokesperson. “Finding lice is a sure way to ruin the holidays, ...
(Date:11/27/2015)... ... November 27, 2015 , ... MPWH, the No.1 Herpes-only dating community in the world, revealed that ... ). More than 3.7 billion people under the age of 50 – or 67% ... WHO's first global estimates of HSV-1 infection . , "The data shocks us highly!" ...
(Date:11/27/2015)... ... 2015 , ... A simply groundbreaking television series, "Voices in America", which is ... an array of issues that are presently affecting Americans. Dedicated to providing the world ... is changing the subjects consumers focus on, one episode at a time. , ...
(Date:11/27/2015)... Los Angeles, CA (PRWEB) , ... November 27, 2015 , ... ... the Commission on Accreditation of Allied Health Education Programs (CAAHEP) awarded accreditation to its ... exclusive list of CAAHEP accredited colleges, as only one of twelve colleges and universities ...
(Date:11/27/2015)... ... November 27, 2015 , ... Avid collector, Andrew Hawley from ... boxing style concert posters. This is one of Joplin's most famous and beautiful concert ... the University of Michigan in Ann Arbor. The According to Hawley, "It is hard ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... 3D bioprinting market is expected ... new report by Grand View Research Inc. Rising prevalence of ... kidney transplantation is expected to boost the market growth, as ... transplantation. --> 3D bioprinting market is expected ... new report by Grand View Research Inc. Rising prevalence of ...
(Date:11/26/2015)... STOCKHOLM , November 26, 2015 /PRNewswire/ ... --> Juntendo universitetssjukhus ser potential att ... av magnetresonansbilder (MR-bilder) för patienter med ... tecknat ett forskningsavtal med SyntheticMR AB för ... kliniska forskningsprojekt på sjukhuset. Med SyMRI kan ...
(Date:11/26/2015)... , Nov. 26, 2015 Research and ... of the "2016 Future Horizons and Growth ... Market: Supplier Shares, Country Segment Forecasts, Competitive Intelligence, ... --> --> ... of the Italian therapeutic drug monitoring market, including ...
Breaking Medicine Technology: