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Racial disparities in surveillance mammography among older breast cancer survivors

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

A Correction to this article was published on 05 June 2019

This article has been updated

Abstract

Background

Despite lower incidence rates among black women and a national decline in breast cancer (BC) deaths, there is a widening gap in BC mortality rates between black and white women in the United States. A previous study evaluating data from 1992 to 1999 found a racial disparity in the receipt of surveillance mammography. We sought to evaluate whether this disparity persists between black and white women diagnosed with BC between 2000 and 2011.

Methods

Using the SEER-Medicare registry, we conducted an analysis of women ≥ 66 years diagnosed with early-stage (0–III) BC between 2000 and 2011 who underwent BC surgery. The primary outcome was receipt of surveillance mammography within 12 months of surgery. Chi square analyses were used to compare characteristics between black and white women. Multivariate logistic regression was used to assess receipt of surveillance mammography after controlling for potential confounders.

Results

There were 3353 black and 40,564 white women in the final cohort. After adjusting for confounders, black women were still 24% less likely than white women to receive surveillance mammography (Odds ratio 0.76, 95% CI 0.70–0.0.82). Those who were married, younger, in the highest income quartile, diagnosed at earlier stages, had a lower comorbidity score, or who resided in metropolitan areas were more likely to receive surveillance mammography (p < 0.05).

Conclusion(s)

We found that older black BC survivors continue to experience lower rates of surveillance mammography, even after adjusting for multiple potential confounders. There remains a need to investigate which individual and systemic factors affect disparities in breast cancer care.

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Data availability

This analysis used data from the Surveillance, Epidemiology and End Results registry linked to Medicare claims (SEER-Medicare). Given concern for patient and provider confidentiality, this dataset is not publicly available, but may be obtained by request and with permission from NCI SEER-Medicare.

Change history

  • 05 June 2019

    In the original publication of the article, under the Methods section, second paragraph, the sentence that reads as “We excluded 3047 patients … surgical treatment (see Fig. 1)” should read as “We excluded 3047 patients who did not identify as black or white, 5395 who were not initially diagnosed with stage 0–III cancer or were missing stage or residence data, 2573 patients who passed away within 18 months of diagnosis, and 4716 patients who did not undergo primary surgical treatment (see Fig. 1)”.

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Funding

This research was supported by a National Cancer Institute Cancer Prevention and Control Career Development Award (1K07CA166462 to JJL).

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Authors and Affiliations

  1. Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA

    Jimmitti Teysir, Juan P. Wisnivesky & Jenny J. Lin

  2. Division of Internal Medicine, Maimonides Medical Center, 4802 10th Avenue, New York, NY, 11219, USA

    Nana Gegechkori

Authors
  1. Jimmitti Teysir
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  2. Nana Gegechkori
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  3. Juan P. Wisnivesky
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  4. Jenny J. Lin
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Corresponding author

Correspondence to Jimmitti Teysir.

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Conflicts of interest

Dr. Wisnivesky is a member of the research board of EHE International, has received consulting honorarium from Merck Pharmaceuticals and IMS Health, and a research grant from Aventis. All other authors are without any conflicts of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

This study used de-identified data from the Surveillance, Epidemiology and End Results registry linked to Medicare claims (SEER-Medicare) and did not require informed consent to be obtained from this database.

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Teysir, J., Gegechkori, N., Wisnivesky, J.P. et al. Racial disparities in surveillance mammography among older breast cancer survivors. Breast Cancer Res Treat 176, 461–467 (2019). https://doi.org/10.1007/s10549-019-05250-8

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