TUESDAY, Oct. 29, 2024 (HealthDay News) — For older patients with breast cancer, non-Hispanic Black race is associated with increased odds of not receiving guideline-concordant care (GCC) and less timely initiation of treatment, according to a study published online Oct. 24 in JAMA Network Open.
Brenda S. Castillo, M.D., from the University of Pennsylvania in Philadelphia, and colleagues conducted a cohort study using data from the National Cancer Database for patients aged 65 years and older with stage I to III breast cancer, diagnosed between 2010 and 2019, to examine whether rates of GCC differed by race. The analytic cohort included 258,531 participants: 9.7 percent identified as non-Hispanic Black and 90.3 percent as non-Hispanic White.
The researchers found that 18.1 and 15.2 percent of non-Hispanic Black and non-Hispanic White participants, respectively, did not receive GCC. In the multivariate analysis, the odds of not receiving GCC were increased for non-Hispanic Black versus non-Hispanic White race (adjusted odds ratio, 1.13). In the univariate analysis, the risk for all-cause mortality was increased 26.1 percent in association with non-Hispanic Black race; after adjustment for GCC and clinical and sociodemographic factors, this percentage was attenuated to 4.7 percent (adjusted hazard ratio, 1.05). Compared with non-Hispanic Black race, non-Hispanic White race was associated with increased odds of initiating treatment within 30, 60, and 90 days of diagnosis (odds ratios, 1.65, 2.11, and 2.39, respectively).
“Optimizing timely receipt of GCC may improve inferior survival outcomes among non-Hispanic Black older adults with breast cancer,” the authors write.
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