Using a disparities dashboard to identify racial/ethnic differences in breast cancer treatment: Implications for improving cancer care delivery.

Authors

null

Megan C. Edmonds

Icahn School of Medicine at Mount Sinai, NY, NY

Megan C. Edmonds, Parul Agarawl, Tara Balija, Nina A. Bickell

Organizations

Icahn School of Medicine at Mount Sinai, NY, NY

Research Funding

No funding received
None.

Background: Delays in the initiation of breast cancer treatment (e.g., surgery, chemotherapy, adjuvant endocrine therapy) contributes to breast cancer survival disparities. Yet, the use of a cancer dashboard to assess and inform real time assessments of the timing of surgery and systemic treatment by race/ethnicity is unclear. The purpose of this study is to investigate whether a cancer disparities dashboard can be used to assess racial/ethnic differences in the initiation of first line of treatment and timeliness of breast cancer surgery. Methods: A disparities dashboard was built using data from the tumor registry and the electronic medical record’s Data Warehouse. Key fields assessing patient race/ethnicity, cancer stage, receptor status, surgery type, treatments received and dates of surgery. This retrospective analysis included women diagnosed with a new primary breast cancer who underwent definitive surgery at Mount Sinai Hospital (2010-2020). We defined delays as >8 weeks to treatment initiation, and delay to breast surgery as > 6 weeks from diagnosis. Chi-square and t tests were used to assess independent variables (e.g., stage, age) by race/ethnicity. Patient-level multivariable logistic regression was used to evaluate the association between race/ethnicity and delays to initiation of first treatment and surgical delays. Results: Of 8,403 women identified (46.5% non-Hispanic White, 17.7% Black, 16.9% Hispanic), 64.5% had stage I cancer, 80.8% had estrogen receptor cancer. 18.5% of the sample had delays to initial treatment and 42.6% experienced delays to surgery. After adjusting for stage, age and receptor status Black patients compared to non-Hispanic White patients had the greatest likelihood of delayed initial treatment (OR: 3.03; 95% CI:2.6-3.5) or surgery delays (OR:2.45; 95% CI:2.1-2.8). With regards to clinical/sociodemographic factors younger patients (22-39 vs. 40-64; p<0.001), mastectomy surgery type (; p=0.031), higher stage (stage 3 vs.1; p<0.0001), HER2 and TNBC receptor status (vs. ER; p<0.0001),) were more likely to experience surgery delays. Conclusions: Breast cancer treatment delays were more common among minoritized patients compared to White counterparts. A Disparities Dashboard can be used to assess differences in care. These data can be used to inform quality initiatives to improve cancer care delivery for at-risk patient populations who experience worse cancer outcomes.

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Abstract Details

Meeting

2023 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session B

Track

Health Care Access, Equity, and Disparities,Technology and Innovation in Quality of Care,Palliative and Supportive Care

Sub Track

Access to Treatment

Citation

JCO Oncol Pract 19, 2023 (suppl 11; abstr 161)

DOI

10.1200/OP.2023.19.11_suppl.161

Abstract #

161

Poster Bd #

D8

Abstract Disclosures