Race/ethnicity and socio-economic differences in breast cancer surgery outcomes

Akinyemiju, Tomi; Vin-Raviv, Neomi; Chavez‐Yenter, Daniel; Zhao, Xueyan; Budhwani, Henna

doi:10.1016/j.canep.2015.07.010

Cited by 51 publications

(35 citation statements)

References 39 publications

(62 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast, several studies have suggested that Blacks suffer poorer outcomes in cancer survival due to delays, receipt, and adherence to cancer treatment (51–64). For example, Akinyemiju et al (2015) performed a cross-sectional analysis among 71,156 women from the NIS and reported that Black women were 23% more likely to have metastatic breast cancer, but 6% less likely to receive mastectomy after breast cancer diagnosis (55). Likewise, much research has shown that Blacks have a higher risk of sepsis when compared to their White counterparts (24–26, 29–33, 65, 66).…”

Section: Discussionmentioning

confidence: 99%

A prospective study of cancer survivors and risk of sepsis within the REGARDS cohort

Moore

Akinyemiju

Bartolucci

et al. 2018

Cancer Epidemiology

View full text Add to dashboard Cite

BACKGROUND Hospitalized cancer patients are nearly 10 times more likely to develop sepsis when compared to patients with no cancer history. We compared the risk of sepsis between cancer survivors and no cancer history participants, and whether race was an effect modifier. METHODS We performed a prospective analysis of data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We categorized participants as “cancer survivors” or “no cancer history” derived from self-reported responses of being diagnosed with any cancer, excluding non-melanoma skin cancer. We defined sepsis as hospitalization for a serious infection with ≥2 systemic inflammatory response syndrome criteria. We performed Cox proportional hazard models to examine the risk of sepsis after cancer (adjusted for sociodemographics, health behaviors, and comorbidities), and stratified by race. RESULTS Among 29,693 eligible participants, 2959 (9.97%) were cancer survivors, and 26,734 (90.03%) were no cancer history participants. Among 1393 sepsis events, the risk of sepsis was higher for cancer survivors (adjusted HR: 2.61, 95% CI: 2.29 – 2.98) when compared to no cancer history participants. Risk of sepsis after cancer survivorship was similar for Black and White participants (p value for race and cancer interaction = 0.63). CONCLUSION In this prospective cohort of community-dwelling adults we observed that cancer survivors had more than a 2.5-fold increased risk of sepsis. Public health efforts should attempt to mitigate sepsis risk by awareness and appropriate treatment (e.g., antibiotic administration) to cancer survivors with suspected infection regardless of the number of years since cancer remission.

show abstract

Section: Discussionmentioning

confidence: 99%

A prospective study of cancer survivors and risk of sepsis within the REGARDS cohort

Moore

Akinyemiju

Bartolucci

et al. 2018

Cancer Epidemiology

View full text Add to dashboard Cite

show abstract

“…A large number of studies have examined the influence of SES, at both the individual and area level, on breast cancer outcomes [4, 5, 7, 9, 19, 21], while a smaller number of studies have examined the influence of HCA on outcomes [4, 5]. However, very few studies have simultaneously accounted for HR subtypes, SES, and healthcare access at the area level.…”

Section: Discussionmentioning

confidence: 99%

“…To date, the causes of breast cancer outcome disparities have not been fully explained, and are likely multifactorial and pervasive across many levels including individual, community, provider, and health systems. The disparity is partly explained by differential access to high-quality screening and healthcare resources [4, 5], factors that operate at both individual and area levels and have been shown to influence stage at diagnosis and receipt of guideline-adherent treatment [6], and therefore survival [7]. Underlying biological differences in breast cancer between Black and White women may also be an underlying cause of disparities in outcomes, particularly in mortality rates [8–10], as Black women are more likely to be diagnosed with aggressive, hormone-receptor (HR)-negative subtypes [10–17].…”

Section: Introductionmentioning

confidence: 99%

“…These differences may be due to inadequate consideration of HR subtypes in addition to upstream socio-economic and healthcare factors. Socioeconomic status has been shown to influence breast cancer survival outcomes when measured at both individual and area levels, with results consistently showing worse outcomes for patients with lower individual and/or area-level SES [7, 19, 23]. Fewer studies have examined other area-level factors such as access to healthcare resources [4, 24, 25], while most studies have focused on examining insurance status.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Racial disparities in individual breast cancer outcomes by hormone-receptor subtype, area-level socio-economic status and healthcare resources

Akinyemiju

Moore

Ojesina

et al. 2016

Breast Cancer Res Treat

View full text Add to dashboard Cite

The aim of the study is to determine the influence of area-level socio-economic status and healthcare access in addition to tumor hormone-receptor subtype on individual breast cancer stage, treatment, and mortality among Non-Hispanic (NH)-Black, NH-White, and Hispanic US adults. Analysis was based on 456,217 breast cancer patients in the SEER database from 2000 to 2010. Multilevel and multivariable-adjusted logistic and Cox proportional hazards regression analysis was conducted to account for clustering by SEER registry of diagnosis. NH-Black women had greater area-level access to healthcare resources compared with women of other races. For instance, the average numbers of oncology hospitals per million population in counties with NH-Black, NH-White, and Hispanic women were 8.1, 7.7, and 5.0 respectively; average numbers of medical doctors per million in counties with NH-Black, NH-White, and Hispanic women were 100.7, 854.0, and 866.3 respectively; and average number of Ob/Gyn in counties with NH-Black, NH-White, and Hispanic women was 155.6, 127.4, and 127.3, respectively (all p values <0.001). Regardless, NH-Black women (HR 1.39, 95 % CI 1.36–1.43) and Hispanic women (HR 1.05, 95 % CI 1.03–1.08) had significantly higher breast cancer mortality compared with NH-White women even after adjusting for hormone-receptor subtype, area-level socioeconomic status, and area-level healthcare access. In addition, lower county-level socio-economic status and healthcare access measures were significantly and independently associated with stage at presentation, surgery, and radiation treatment as well as mortality after adjusting for age, race/ethnicity, and HR subtype. Although breast cancer HR subtype is a strong, important, and consistent predictor of breast cancer outcomes, we still observed significant and independent influences of area-level SES and HCA on breast cancer outcomes that deserve further study and may be critical to eliminating breast cancer outcome disparities.

show abstract

“…Advanced randomized researches prove purposefulness of early detection and constant monitoring of these disorders for timely overcoming of negative functional disorders and improvement of life quality of women of this nosology [4,5,8,9,[13][14][15][16][17][18][19][20][21][22][23][24]. However, in most cases orientation on medical component of rehabilitation, working out of modern schemas of medicine provisioning, implementation of reconstructive plastic surgery, prevail.…”

mentioning

confidence: 99%

Improvement of upper limb’s condition of women with post mastectomy syndrome with the help of problem-oriented program of physical rehabilitation

Briskin

Odinets

2015

PPS

View full text Add to dashboard Cite

Abstract. Purpose: to determine effectiveness of problem-oriented program of women's physical rehabilitation with post mastectomy syndrome in improvement of upper limb's functional state. Material: 50 women with early symptoms of post mastectomy syndrome at stationary rehabilitation stage, who underwent radical mastectomy by Madden were involved in the research. Testing of movement amplitude in shoulder joint, swelling of upper limb and muscular strength of hand's flexors was conducted on 2 nd day after surgery and at the end of stationary rehabilitation period (12-14 th day). Results: Main means of the authors' program were: general and special physical exercises; static and dynamic breathing exercises; breathing through preloaded lips, controlled coughing, autogenic drainage, manual pressing, manual vibration; post-isometric relaxation; elements of labor therapy; lymphatic drainage massage and self massage; topical talks; consultations; auto training. The trainings were conducted individually 2-3 times a day; 20-30 minutes every session. The patients' independent trainings included: fulfillment of therapeutic positions, self-massage, relaxation exercises and auto-training. Conclusions: application of problem-oriented physical rehabilitation program facilitates improvement of upper limb's functional potentials of women with post mastectomy syndrome.

show abstract

Race/ethnicity and socio-economic differences in breast cancer surgery outcomes

Cited by 51 publications

References 39 publications

A prospective study of cancer survivors and risk of sepsis within the REGARDS cohort

A prospective study of cancer survivors and risk of sepsis within the REGARDS cohort

Racial disparities in individual breast cancer outcomes by hormone-receptor subtype, area-level socio-economic status and healthcare resources

Improvement of upper limb’s condition of women with post mastectomy syndrome with the help of problem-oriented program of physical rehabilitation

Contact Info

Product

Resources

About