Racial disparities in omission of oncotype DX but no racial disparities in chemotherapy receipt following completed oncotype DX test results

David J. Press, Abiola Ibraheem, M. Eileen Dolan, Kathleen H. Goss, Suzanne Conzen, Dezheng Huo

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: To examine racial/ethnic disparities in Oncotype DX (ODX) testing among patients with node-negative, estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancers and possible racial/ethnic disparities in chemotherapy receipt following ODX testing within Recurrence Score (RS) category (Not Done, Low, Intermediate, High), as well as chemotherapy receipt time trends within RS categories. Methods: A retrospective cohort list of 125,288 women who were potentially indicated for ODX testing from 2010 to 2014 was obtained using the National Cancer Database. We fit multivariate logistic regression predicting chemotherapy receipt, adjusting for clinical factors, patient demographic factors, and hospital-level factors, separately by RS category, and calculated odds ratios (OR) and 95% confidence intervals (CI), as well as time trends. Results: Overall, ODX testing was completed for 46.1% of Non-Hispanic (NH) Whites, 43.9% of NH Blacks, and 41.7% of Hispanics. Among patients who did not receive ODX testing, NH Black and Hispanic women both experienced statistically significant increases in chemotherapy receipt relative to NH White women (NH Black OR 1.23; 95% CI 1.11–1.37; Hispanic OR 1.23; 95% CI 1.07–1.42). However, among patients with ODX results, no statistically significant racial/ethnic differences in chemotherapy receipt were observed within strata of RS category. Trend analyses demonstrated increasing adherence to national guidelines for ODX testing. Conclusions: We identified racial disparities in omission of ODX testing but no differences in chemotherapy receipt if ODX test results were obtained, suggesting increasing access to ODX testing may improve racial equality in efficacious use of adjuvant chemotherapy for ER-positive HER2-negative breast cancer.

Original languageEnglish (US)
Pages (from-to)207-220
Number of pages14
JournalBreast Cancer Research and Treatment
Volume168
Issue number1
DOIs
StatePublished - Feb 1 2018
Externally publishedYes

Fingerprint

Drug Therapy
Hispanic Americans
Recurrence
Odds Ratio
Confidence Intervals
Estrogen Receptors
Breast Neoplasms
Adjuvant Chemotherapy
Logistic Models
Demography
Databases
Guidelines
Neoplasms
human ERBB2 protein

Keywords

  • Breast cancer
  • Chemotherapy
  • Oncotype DX
  • Racial disparities

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Racial disparities in omission of oncotype DX but no racial disparities in chemotherapy receipt following completed oncotype DX test results. / Press, David J.; Ibraheem, Abiola; Dolan, M. Eileen; Goss, Kathleen H.; Conzen, Suzanne; Huo, Dezheng.

In: Breast Cancer Research and Treatment, Vol. 168, No. 1, 01.02.2018, p. 207-220.

Research output: Contribution to journalArticle

Press, David J. ; Ibraheem, Abiola ; Dolan, M. Eileen ; Goss, Kathleen H. ; Conzen, Suzanne ; Huo, Dezheng. / Racial disparities in omission of oncotype DX but no racial disparities in chemotherapy receipt following completed oncotype DX test results. In: Breast Cancer Research and Treatment. 2018 ; Vol. 168, No. 1. pp. 207-220.
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abstract = "Purpose: To examine racial/ethnic disparities in Oncotype DX (ODX) testing among patients with node-negative, estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancers and possible racial/ethnic disparities in chemotherapy receipt following ODX testing within Recurrence Score (RS) category (Not Done, Low, Intermediate, High), as well as chemotherapy receipt time trends within RS categories. Methods: A retrospective cohort list of 125,288 women who were potentially indicated for ODX testing from 2010 to 2014 was obtained using the National Cancer Database. We fit multivariate logistic regression predicting chemotherapy receipt, adjusting for clinical factors, patient demographic factors, and hospital-level factors, separately by RS category, and calculated odds ratios (OR) and 95{\%} confidence intervals (CI), as well as time trends. Results: Overall, ODX testing was completed for 46.1{\%} of Non-Hispanic (NH) Whites, 43.9{\%} of NH Blacks, and 41.7{\%} of Hispanics. Among patients who did not receive ODX testing, NH Black and Hispanic women both experienced statistically significant increases in chemotherapy receipt relative to NH White women (NH Black OR 1.23; 95{\%} CI 1.11–1.37; Hispanic OR 1.23; 95{\%} CI 1.07–1.42). However, among patients with ODX results, no statistically significant racial/ethnic differences in chemotherapy receipt were observed within strata of RS category. Trend analyses demonstrated increasing adherence to national guidelines for ODX testing. Conclusions: We identified racial disparities in omission of ODX testing but no differences in chemotherapy receipt if ODX test results were obtained, suggesting increasing access to ODX testing may improve racial equality in efficacious use of adjuvant chemotherapy for ER-positive HER2-negative breast cancer.",
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T1 - Racial disparities in omission of oncotype DX but no racial disparities in chemotherapy receipt following completed oncotype DX test results

AU - Press, David J.

AU - Ibraheem, Abiola

AU - Dolan, M. Eileen

AU - Goss, Kathleen H.

AU - Conzen, Suzanne

AU - Huo, Dezheng

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Purpose: To examine racial/ethnic disparities in Oncotype DX (ODX) testing among patients with node-negative, estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancers and possible racial/ethnic disparities in chemotherapy receipt following ODX testing within Recurrence Score (RS) category (Not Done, Low, Intermediate, High), as well as chemotherapy receipt time trends within RS categories. Methods: A retrospective cohort list of 125,288 women who were potentially indicated for ODX testing from 2010 to 2014 was obtained using the National Cancer Database. We fit multivariate logistic regression predicting chemotherapy receipt, adjusting for clinical factors, patient demographic factors, and hospital-level factors, separately by RS category, and calculated odds ratios (OR) and 95% confidence intervals (CI), as well as time trends. Results: Overall, ODX testing was completed for 46.1% of Non-Hispanic (NH) Whites, 43.9% of NH Blacks, and 41.7% of Hispanics. Among patients who did not receive ODX testing, NH Black and Hispanic women both experienced statistically significant increases in chemotherapy receipt relative to NH White women (NH Black OR 1.23; 95% CI 1.11–1.37; Hispanic OR 1.23; 95% CI 1.07–1.42). However, among patients with ODX results, no statistically significant racial/ethnic differences in chemotherapy receipt were observed within strata of RS category. Trend analyses demonstrated increasing adherence to national guidelines for ODX testing. Conclusions: We identified racial disparities in omission of ODX testing but no differences in chemotherapy receipt if ODX test results were obtained, suggesting increasing access to ODX testing may improve racial equality in efficacious use of adjuvant chemotherapy for ER-positive HER2-negative breast cancer.

AB - Purpose: To examine racial/ethnic disparities in Oncotype DX (ODX) testing among patients with node-negative, estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancers and possible racial/ethnic disparities in chemotherapy receipt following ODX testing within Recurrence Score (RS) category (Not Done, Low, Intermediate, High), as well as chemotherapy receipt time trends within RS categories. Methods: A retrospective cohort list of 125,288 women who were potentially indicated for ODX testing from 2010 to 2014 was obtained using the National Cancer Database. We fit multivariate logistic regression predicting chemotherapy receipt, adjusting for clinical factors, patient demographic factors, and hospital-level factors, separately by RS category, and calculated odds ratios (OR) and 95% confidence intervals (CI), as well as time trends. Results: Overall, ODX testing was completed for 46.1% of Non-Hispanic (NH) Whites, 43.9% of NH Blacks, and 41.7% of Hispanics. Among patients who did not receive ODX testing, NH Black and Hispanic women both experienced statistically significant increases in chemotherapy receipt relative to NH White women (NH Black OR 1.23; 95% CI 1.11–1.37; Hispanic OR 1.23; 95% CI 1.07–1.42). However, among patients with ODX results, no statistically significant racial/ethnic differences in chemotherapy receipt were observed within strata of RS category. Trend analyses demonstrated increasing adherence to national guidelines for ODX testing. Conclusions: We identified racial disparities in omission of ODX testing but no differences in chemotherapy receipt if ODX test results were obtained, suggesting increasing access to ODX testing may improve racial equality in efficacious use of adjuvant chemotherapy for ER-positive HER2-negative breast cancer.

KW - Breast cancer

KW - Chemotherapy

KW - Oncotype DX

KW - Racial disparities

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