PMID- 37686609
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230911
IS  - 2072-6694 (Print)
IS  - 2072-6694 (Electronic)
IS  - 2072-6694 (Linking)
VI  - 15
IP  - 17
DP  - 2023 Aug 30
TI  - Racial Disparities in Breast Cancer Treatments and Adverse Events in the 
      SEER-Medicare Data.
LID - 10.3390/cancers15174333 [doi]
LID - 4333
AB  - Despite lower incidence rates, African American (AA) patients have shorter 
      survival from breast cancer (BC) than white (W) patients. Multiple factors 
      contribute to decreased survival, including screening disparities, later 
      presentation, and access to care. Disparities in adverse events (AEs) may 
      contribute to delayed or incomplete treatment, earlier recurrence, and shortened 
      survival. Here, we analyzed the SEER-Medicare dataset, which captures claims from 
      a variety of venues, in order to determine whether the cancer care venues affect 
      treatment and associated adverse events. We investigated a study population whose 
      claims are included in the Outpatient files, consisting of hospital and 
      healthcare facility venues, and a study population from the National Claims 
      History (NCH) files, consisting of claims from physicians, office practices, and 
      other non-institutional providers. We demonstrated statistically and 
      substantively significant venue-specific differences in treatment rates, drugs 
      administered, and AEs from treatments between AA and W patients. We showed that 
      AA patients in the NCH dataset received lower rates of treatment, but patients in 
      the Outpatient dataset received higher rates of treatment than W patients. The 
      rates of recorded AEs per treatment were higher in the NCH setting than in the 
      Outpatient setting in all patients. AEs were consistently higher in AA patients 
      than in W patients. AA patients had higher comorbidity indices and were younger 
      than W patients, but these variables did not appear to play roles in the AE 
      differences. The frequency of specific anticancer drugs administered in cancer- 
      and venue-specific circumstances and their associated AEs varied between AA and W 
      patients. The higher AE rates were due to slightly higher frequencies in the 
      administration of drugs with higher associated AE rates in AA patients than in W 
      patients. Our investigations demonstrate significant differences in treatment 
      rates and associated AEs between AA and W patients with BC, depending on the 
      venues of care, likely contributing to differences in outcomes.
FAU - Wieder, Robert
AU  - Wieder R
AUID- ORCID: 0000-0002-1005-493X
AD  - Rutgers New Jersey Medical School and the Cancer Institute of New Jersey, 185 
      South Orange Avenue, MSB F671, Newark, NJ 07103, USA.
FAU - Adam, Nabil
AU  - Adam N
AUID- ORCID: 0000-0002-9931-9972
AD  - Phalcon, LLC, Manhasset, NY 11030, USA.
LA  - eng
GR  - N/A (RW and NA)/2020 Busch Biomedical Grant Program, USA/
GR  - GG014586-02 (RW and NA)/Northeast Big Data Innovation Hub, USA/
GR  - CC ADV 00011104 2023 TR. (RW and NA)/Amazon Web Services Health Equity Initiative 
      ("HEI") Program, USA/
PT  - Journal Article
DEP - 20230830
PL  - Switzerland
TA  - Cancers (Basel)
JT  - Cancers
JID - 101526829
PMC - PMC10486612
OTO - NOTNLM
OT  - SEER-Medicare
OT  - adverse events
OT  - biological therapy
OT  - breast cancer treatment
OT  - chemotherapy
OT  - hormone therapy
OT  - racial disparities
COIS- The authors declare no conflict of interest.
EDAT- 2023/09/09 11:47
MHDA- 2023/09/09 11:48
PMCR- 2023/08/30
CRDT- 2023/09/09 01:15
PHST- 2023/07/26 00:00 [received]
PHST- 2023/08/15 00:00 [revised]
PHST- 2023/08/23 00:00 [accepted]
PHST- 2023/09/09 11:48 [medline]
PHST- 2023/09/09 11:47 [pubmed]
PHST- 2023/09/09 01:15 [entrez]
PHST- 2023/08/30 00:00 [pmc-release]
AID - cancers15174333 [pii]
AID - cancers-15-04333 [pii]
AID - 10.3390/cancers15174333 [doi]
PST - epublish
SO  - Cancers (Basel). 2023 Aug 30;15(17):4333. doi: 10.3390/cancers15174333.