14 DAY TRIAL // A recent study carried out by a team led by Rachel Freedman, MD, MPH, of the Dana-Farber Cancer Institute in Boston, found out that insurance and social and economic status have nothing to do with disparities in breast cancer care, the only influential factor remaining skin color.
Dr Freedman looked at recommended breast cancer care for a large sample of women – 662,117 white, black and Hispanic, who had been diagnosed with breast cancer, to see whether insurance and socioeconomic factors were linked to the racial/ethnic differences in treatment.
The women had been diagnosed with invasive breast cancer, from 1998 to 2005, and the data coming from the National Cancer Data Base (NCDB) hospitals, included localized therapy, hormone receptor testing, hormonal therapy, and chemotherapy.
86% of the participants were white women, 10% were black and 4% were Hispanic, and 51% had private insurance, while 41% had Medicare.
The study showed that white women are more likely to receive recommended breast cancer treatments than black and Hispanic women, and this has nothing to do with the patients' socioeconomic status or health insurance.
Unlike white women, black patients had 0.91 times lower chances of receiving recommended local therapy, 0.90 times lower odds of receiving hormonal therapy and 0.87 lower odds of receiving chemotherapy.
Hispanic women also had lower chances of receiving hormonal therapy than white women.
Race or ethnicity had no influence on the hormone receptor testing, and these small, but existing, racial disparities remained even after accounting for health insurance and socioeconomic status.
Dr Friedman said that “although health insurance expansion may resolve disparities in treatment by health insurance status, this study suggests that expansion alone is unlikely to have a major impact on disparities in breast cancer care among black women.
The authors of the study suggest that there are serious efforts to be made in order to better assess disparities in breast cancer care, and to make sure very women, regardless of race or ethnicity, gets the best and most appropriate treatment.
The study was published early online in Cancer, a peer-reviewed journal of the American Cancer Society.