New perspectives on health disparities in breast cance...(e considered optional such as for elder...),Health

Ideally, factors such as race and insurance status shouldnt play any role in who receives this procedure, yet that is what we found. And while age is an important factor in deciding whether or not to perform lymph node assessments, we certainly didnt expect a three-fold difference, Halpern said.

Other studies have indicated that disparities in care may result from three different sources: structural barriers (such as health insurance or type of hospital), physician/clinical factors, and patient factors. All three of these may be important in the disparities we observed for axillary node dissection, Halpern said.

These disparities could result from differences in sites of care or practice patterns among healthcare providers that predominantly treat poor or uninsured women, or could reflect appropriate application of clinical guidelines in some cases, Halpern said. We cant be sure why these disparities occur, because we just dont know how those decisions are being made at the patient and physician levels.

To conduct the study, researchers examined data from 196,732 patients who had surgery to treat early stage breast cancer from 2003-2005 from the National Cancer Database, a hospital-based registry sponsored by the ACS and the American College of Surgeons. All of these hospitals had cancer programs accredited by the Commission on Cancer; approximately 70 percent of cancer patients nationwide are treated at these hospitals.

We need to find out why these disparities exist and what to do to make sure that everyone is getting excellent cancer care, Halpern said.

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