Receipt of Standard Breast Cancer Treatment by African American and White Women

OBJECTIVES Breast cancer mortality is higher among African Americans than for Whites, though their breast cancer incidence is lower. This study examines whether this disparity may be due to differential receipt of treatment defined as "standard of care" or "addition to standard of care" by the National Comprehensive Cancer Network (NCCN). DESIGN Incident, female breast cancer cases, 2,203 African American and 7,518 White, diagnosed during 1996-2002 were identified from the Alabama Statewide Cancer Registry. Breast cancer treatment was characterized as whether or not a woman received standard of care as defined by the NCCN. For cases characterized as receiving standard of care, addition to standard of care was also evaluated, defined as receiving at least one additional treatment modality according to NCCN guidelines. Logistic models were used to evaluate racial differences in standard and addition to standard of care and to adjust for age, stage at diagnosis, year of diagnosis and area of residence. RESULTS No racial differences were found for standard (Prevalence Ratio (PR)=1.00) or for addition to standard of care (PR=1.00) after adjustment for confounders. When the adjusted models were examined separately by age, stage, and area of residence, overall no racial differences were found. CONCLUSION No racial differences in standard of care and addition to standard of care for breast cancer treatment were found. Therefore, both African Americans and Whites received comparable treatment according to NCCN guidelines.