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. 2024 Feb;203(3):553-564.
doi: 10.1007/s10549-023-07148-y. Epub 2023 Oct 31.

Racial/ethnic disparities in the association between patient care experiences and receipt of initial surgical breast cancer care: findings from SEER-CAHPS

Mariana Arevalo  1   2 , Trevor A Pickering  3 , Sally W Vernon  4 , Kayo Fujimoto  4 , Melissa F Peskin  4 , Albert J Farias  5   6   7
Affiliations

Racial/ethnic disparities in the association between patient care experiences and receipt of initial surgical breast cancer care: findings from SEER-CAHPS

Mariana Arevalo et al. Breast Cancer Res Treat. 2024 Feb.

Abstract

Purpose: We determined whether racial/ethnic differences in patient experiences with care influence timeliness and type of initial surgical breast cancer treatment for a sample of female Medicare cancer patients.

Methods: We conducted a retrospective cohort study using the linked Epidemiology and End Results-Consumer Assessment of Healthcare Providers and Systems (SEER-CAHPS) dataset. The outcomes were: (1) time-to-initial surgical treatment, and (2) type of treatment [breast conserving surgery (BCS) vs. mastectomy]. The indicators were reports of four types of patient experiences with care including doctor communication, getting care quickly, getting needed care, and getting needed Rx. Interaction terms in each multivariable logistic model examined if the associations varied by race/ethnicity.

Results: Of the 2069 patients, 84.6% were White, 7.6% Black and 7.8% Hispanic. After adjusting for potential confounders, non-Hispanic Black patients who provided excellent reports of their ability to get needed prescriptions had lower odds of receiving surgery within 2-months of diagnosis, compared to NH-Whites who provided less than excellent reports (aOR: 0.29, 95% CI 0.09-0.98). There were no differences based on 1-month or 3-month thresholds. We found no other statistically significant effect of race/ethnicity. As to type of surgery, among NH Blacks, excellent reports of getting care quickly were associated with higher odds of receiving BCS versus mastectomy (aOR: 2.82, 95% CI 1.16-6.85) compared to NH Whites with less than excellent reports. We found no other statistically significant differences by race/ethnicity.

Conclusion: Experiences with care are measurable and modifiable factors that can be used to assess and improve aspects of patient-centered care. Improvements in patient care experiences of older adults with cancer, particularly among minorities, may help to eliminate racial/ethnic disparities in timeliness and type of surgical treatment.

Keywords: Cancer treatment; Inequities; Neoplasm; Quality care; Surgery; Survivorship.

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Conflict of interest statement

Conflict of interest Authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
CONSORT diagram for study population
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References

    1. United States Cancer Statistics Working Group (2020) “U.S. Cancer Statistics Data Visualizations Tool, based on 2019 submission data (1999–2017).” United States Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute. www.cdc.gov/cancer/dataviz. Released in June 2020. Accessed June, 2020
    1. American Cancer Society (2019) “Breast Cancer Facts and Figures 2019–2020, ” American Cancer Society, Atlanta, 2019. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-...
    1. Moo TA, Sanford R, Dang C, Morrow M (2018) Overview of breast cancer therapy. PET Clin 13(3):339–354 - PMC - PubMed
    1. Halpern M, Holden D (2012) Disparities in timeliness of care for US Medicare patients diagnosed with cancer. Curr Oncol 19(6):e404. - PMC - PubMed
    1. Wright GP, Wong JH, Morgan JW, Roy-Chowdhury S, Kazanjian K, Lum SS (2010) Time from diagnosis to surgical treatment of breast cancer: factors influencing delays in initiating treatment. Am Surg 76(10):1119–1122 - PubMed