Journal of Neuro-Oncology

, Volume 101, Issue 1, pp 67–74

Treatment disparities following the diagnosis of an astrocytoma

  • Paula R. Sherwood
  • Bassam A. Dahman
  • Heidi S. Donovan
  • Arlan Mintz
  • Charles W. Given
  • Cathy J. Bradley
Clinical Study – Patient Study

DOI: 10.1007/s11060-010-0223-8

Cite this article as:
Sherwood, P.R., Dahman, B.A., Donovan, H.S. et al. J Neurooncol (2011) 101: 67. doi:10.1007/s11060-010-0223-8

Abstract

Post-operative radiation and chemotherapy following diagnosis of astrocytoma are standard care. No research has examined racial or insurance-based disparities in treatment receipt. The purpose of this study was to evaluate whether African Americans and patients with dual eligibility in Medicare and Medicaid (DE), compared to Caucasians and patients with Medicare alone, experienced differences in (1) seeing a radiation oncologist, (2) receiving radiation or chemotherapy, and (3) overall survival. Using a retrospective descriptive design, statewide Medicaid and Medicare data were merged with the Michigan Tumor Registry to extract a sample of patients (n = 604) ≥65 years old with a first primary astrocytoma diagnosis in Michigan between 1996 and 2000. There were no racial or insurance-based differences in reporting a claim for a radiation oncologist. Controlling for age, income, surgical intervention, residence population, comorbidities, gender, and stage, African Americans were less likely to report radiation claims than Caucasians (OR = 0.20; 95% CI = 0.07–0.54). DE patients were less likely to report radiation claims (OR = 0.50; 95% CI = 0.26–0.94) than those with Medicare only. These differences were not seen with chemotherapy. When only those with a glioblastoma multiforme were examined, DE patients (OR = 0.47; 95% CI = 0.24–0.92) and African Americans (OR = 0.13; 95% CI = 0.04–0.44) were much less likely to report radiation claims. Race and insurance status did not significantly affect survival, although income did. Data suggest disparities in race and insurance status may exist in receiving standard of care for astrocytomas. Further research is warranted to replicate the data and determine potential sources for these disparities.

Keywords

Astrocytoma Brain tumor Chemotherapy Disparity Radiation Income Race 

Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • Paula R. Sherwood
    • 1
    • 2
  • Bassam A. Dahman
    • 3
  • Heidi S. Donovan
    • 1
  • Arlan Mintz
    • 4
  • Charles W. Given
    • 5
  • Cathy J. Bradley
    • 3
  1. 1.School of NursingUniversity of PittsburghPittsburghUSA
  2. 2.Department of Neurosurgery, School of MedicineUniversity of PittsburghPittsburghUSA
  3. 3.Department of Health Administration, Massey Cancer CenterVirginia Commonwealth UniversityRichmondUSA
  4. 4.Department of Neurosurgery, School of MedicineUniversity of PittsburghPittsburghUSA
  5. 5.School of Medicine, B108 Clinical CenterMichigan State UniversityEast LansingUSA

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