Guideline-Concordant Care Less Likely With Non-Hispanic Black Race

TUESDAY, Oct. 29, 2024 (HealthDay News) — For older breast cancer patients, non-Hispanic black race is associated with increased risk of not receiving guideline-consistent care (GCC) and early less rapid processing, according to a study published online October 24 in Open JAMA Network.

Brenda S. Castillo, MD, of the University of Pennsylvania in Philadelphia, and colleagues conducted a cohort study using data from the National Cancer Database for patients aged 65 and older with breast cancer stage I to III, diagnosed between 2010 and 2019, to examine whether rates of GCC differed by race. The analytic cohort included 258,531 participants: 9.7% identified as non-Hispanic black and 90.3% as non-Hispanic white.

The researchers found that 18.1 and 15.2 percent of non-Hispanic black and non-Hispanic white participants, respectively, did not receive the GCC. In multivariate analysis, the odds of not receiving GCC were increased for non-Hispanic black people compared to non-Hispanic white people (adjusted odds ratio, 1.13). In univariate analysis, the risk of all-cause mortality increased by 26.1 percent in association with non-Hispanic black race; after adjusting for GCC and clinical and sociodemographic factors, this percentage was attenuated to 4.7 percent (adjusted hazard ratio, 1.05). Compared with non-Hispanic black race, non-Hispanic white race was associated with increased odds of initiating treatment within 30, 60, and 90 days of diagnosis (odds ratios, 1.65, 2.11, and 2. 39, respectively).

“Optimizing timely receipt of GCC may improve poor survival outcomes among non-Hispanic black older adults with breast cancer,” the authors write.

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