Investigating Racial Disparities in Survival Outcomes Among Women Treated for Breast Cancer in Atlanta
Posted: Thursday, November 11, 2021
Recent study findings presented in JNCCN–Journal of the National Comprehensive Cancer Network investigated racial disparities in the survival outcomes of women treated for breast cancer in metropolitan Atlanta. Although guideline-concordant care seemed to play an important role in a patient’s overall prognosis, there appeared to be no evidence that the differences in the receipt of that care contribute to a difference in outcomes between non-Hispanic Black and non-Hispanic White women. Black women consistently had worse breast cancer survival rates than White women regardless of guideline-concordant care status, concluded Lauren E. McCullough, PhD, of the Rollins School of Public Health at Emory University, and colleagues.
In this study, the authors identified 7,046 women diagnosed with breast cancer using the Georgia Cancer Registry. The trial evaluated 2,784 Non-Hispanic Black women and 4,261 Non-Hispanic White women. All patients had an invasive stage I to III first primary breast tumor, information available assigning tumor subtype, and had received surgery as part of their local therapy.
The authors found that, compared with their White counterparts, Black women were younger, less likely to have private health insurance, and less likely to live in a high socioeconomic-status neighborhood. Both groups received similar rates of guideline-concordant care (65% in Black women and 63% in White women), regardless of the cancer subtype. The only exception was in hormone receptor–negative/HER2-positive disease, for which Black women were less likely to receive guideline-concordant care than White women (66% vs. 72%, respectively).
Overall, the racial disparity in breast cancer mortality was 1.98, which continued even within the strata of the receipt of overall guideline-concordant care. In women who received guideline-concordant care, across all treatment modalities, the authors found a twofold increase in the Black to White hazard of breast cancer mortality. Additionally, White women who received guideline=discordant care had no greater risk of mortality than did White women who received guideline-concordant care. Conversely, Black women had a twofold increase in mortality regardless of their care status.
Disclosure: For full disclosures of the study authors, visit jnccn.org.
