Impact of socioeconomic and medical factors on racial disparities in time to treatment initiation and survival in breast cancer patients

Autor: Diana Basali, Emily Craig Zabor, Jacob Lindberg, Brittany Peterre, Jacqulyn Tomer, Halle C. F. Moore
Rok vydání: 2022
Předmět:
Zdroj: Journal of Clinical Oncology. 40:e18583-e18583
ISSN: 1527-7755
0732-183X
DOI: 10.1200/jco.2022.40.16_suppl.e18583
Popis: e18583 Background: Delays in breast cancer treatment have been associated with adverse outcomes. Previously, we observed longer time to treatment initiation (TTT) and inferior overall survival (OS) among Black versus White patients with breast cancer. We aim to examine the extent to which social, and medical factors influence these outcomes. Methods: Women over age 18 who identified as Black or White and diagnosed with stage I-IV breast cancer between 2015 and 2020 at the Cleveland Clinic were identified. Variables included were age, race, type of insurance, receptor status, hypertension, type 2 diabetes, CKD stage 3/4, obesity, and tobacco use. Characteristics according to race were analyzed by the Chi-squared test for categorical variables and the Wilcoxon rank sum test for continuous variables. The primary outcomes were TTT and OS. TTT was analyzed using multivariable linear regression and OS was analyzed using multivariable Cox regression. Results: Patient characteristics by race are shown in Table. Black patients were older, more frequently had triple-negative (TN) receptor status and comorbidities, and less frequently had private insurance. On multivariable linear regression Black race and increased age were associated with longer TTT (both p < 0.001) whereas TN vs HR+/HER2- was associated with shorter TTT (p = 0.007). On multivariable Cox regression Black race (HR 1.39; p = 0.009), increased age (HR 1.02; p < 0.001), Medicaid/Medicare (HR 1.91) or other insurance (HR 1.68) vs private insurance (p < 0.001), type 2 diabetes (HR 1.55; p = 0.001), CKD stage 3/4 (HR 1.93; p < 0.001), and HER2+ (HR 1.44) or TN (HR 2.41) vs HR+/HER2- (p < 0.001) were associated with increased hazard of death .Obesity (HR 0.73; p
Databáze: OpenAIRE
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