Health disparities: genetics plays an important role in cancer detection, prognosis among minorities

“With this intervention, we were attempting to target the ‘system failures,’ cases in which the surgeon recommended treatment, the patient did not refuse, but care did not ensue,” Mohan said. “We found that once surgeons were made aware that their patients were not using available therapy, they felt compelled to intervene and were equipped with the appropriate data to take action.”

Use of consultations increased from 85 to 96 percent in minority women, and 82 to 97 percent in non-minorities. Overall, women were more likely to take advantage of treatment options, particularly chemotherapy and hormone therapy. Among African-American and Hispanic women, underuse of radiotherapy decreased from 23 to 10 percent.

Following the intervention, race no longer played a significant role in whether or not women connected with a subsequent oncology consultation (OR=1.20; 95% CI, 0.69-2.08) or took advantage of therapy (OR=1.13; 95% CI, 0.73-1.75).

“This could reduce the racial disparity in breast cancer treatment and subsequently impact health outcomes,” Mohan said. “We conducted this tracking and feedback process at six centers, but it has the potential to be expanded to other institutions, perhaps in an automated fashion.”

Is recent decline in breast cancer incidence equal across different US racial groups? Abstract 3839

Adding data to an ongoing debate about the causes of a recent decline in breast cancer incidence, researchers report that the decline is confined to white women and may be due to their use of hormone replacement therapy to treat symptoms of menopause.

“Non-Hispanic whites were more likely to use hormone replacement therapy, and had similar percent reduction of discontinuation after the [U.S. Food and Drug Administration] warned about its link to breast cancer in 2003, so the benefit of a reduction in breast cancer was more pronounced,” said Dezheng Huo, M.D., Ph.D., research associate professor in the Health Studies Department at the University of Chicago.

Between 2002 and 2003, scientists observed a sharp decline in breast cancer incidence in the United States but only among women older than 50 years who had estrogen-receptor positive cancer. Reasons for the decline have been hotly debated in the research and medical community.

Using data from the National Cancer Institute’s Surveillance, Epidemiology and End Results Database, Huo and colleagues calculated rates of breast cancer between 2000 and 2004 to confirm that the reductions were restricted to a certain breast cancer type and to determine whether or not the reductions were similar across racial and ethnic groups.

“The sharp reductions seen in Caucasians aged 50 to 69 years were not seen among other ethnic groups,” Huo said.