Age and Racial Disparities in the Utilization of Anticancer, Antihypertension, and Anti-diabetes Therapies, and in Mortality in a Large Population-Based Cohort of Older Women with Breast Cancer
Objective This study examined the receipt of therapies for cancer, hypertension, and diabetes in association with age and racial disparities in mortality among women with breast cancer. Methods This study identified 92,829 women diagnosed with breast cancer at age ≥ 65 years in 2007–2015 with follow...
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| Veröffentlicht in: | Journal of racial and ethnic health disparities 2023-02, Vol.10 (1), p.446-461 |
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| creator | Du, Xianglin L. Song, Lulu |
| description | Objective
This study examined the receipt of therapies for cancer, hypertension, and diabetes in association with age and racial disparities in mortality among women with breast cancer.
Methods
This study identified 92,829 women diagnosed with breast cancer at age ≥ 65 years in 2007–2015 with follow-up to 2016 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database.
Results
There were substantial age and racial disparities in the prevalence of hypertension and diabetes, which was higher in women ≥ 75 (86.3% and 32.0%) than younger women 65–74 (72.8% and 29.3%), and the highest in Black women (91.1% and 49.1%), followed by Asian women (80.2% and 40.5%), and White women (77.6 and 27.8%). Black women were significantly less likely to receive chemotherapy (odds ratio: 0.70, 95% CI: 0.64–0.75), radiation therapy (0.87, 0.83–0.92), and hormone therapy (0.80, 0.76–0.85), but significantly more likely to receive antihypertensive (1.26, 1.19–1.33) and antidiabetic (1.19, 1.10–1.28) drugs than White women, after adjusting for sociodemographic and tumor factors. As compared to White women, Black women had a significantly higher risk of all-cause mortality (1.46, 1.41–1.52), but it became insignificant after adjusting for treatment factors (1.01, 0.97–1.06), whereas the adjusted risk of breast cancer-specific mortality remained significantly higher (1.08, 1.01–1.15) in Black women; Asian and other ethnic women had a significantly lower risk of all-cause and breast cancer-specific mortality.
Conclusions
There were substantial age and racial disparities in the prevalence of hypertension and diabetes and in the receipt of medications. Black women did not have a significantly higher risk of all-cause mortality but had a significantly higher risk of breast cancer-specific mortality as compared to White women. |
| doi_str_mv | 10.1007/s40615-022-01235-4 |
| format | Article |
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This study examined the receipt of therapies for cancer, hypertension, and diabetes in association with age and racial disparities in mortality among women with breast cancer.
Methods
This study identified 92,829 women diagnosed with breast cancer at age ≥ 65 years in 2007–2015 with follow-up to 2016 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database.
Results
There were substantial age and racial disparities in the prevalence of hypertension and diabetes, which was higher in women ≥ 75 (86.3% and 32.0%) than younger women 65–74 (72.8% and 29.3%), and the highest in Black women (91.1% and 49.1%), followed by Asian women (80.2% and 40.5%), and White women (77.6 and 27.8%). Black women were significantly less likely to receive chemotherapy (odds ratio: 0.70, 95% CI: 0.64–0.75), radiation therapy (0.87, 0.83–0.92), and hormone therapy (0.80, 0.76–0.85), but significantly more likely to receive antihypertensive (1.26, 1.19–1.33) and antidiabetic (1.19, 1.10–1.28) drugs than White women, after adjusting for sociodemographic and tumor factors. As compared to White women, Black women had a significantly higher risk of all-cause mortality (1.46, 1.41–1.52), but it became insignificant after adjusting for treatment factors (1.01, 0.97–1.06), whereas the adjusted risk of breast cancer-specific mortality remained significantly higher (1.08, 1.01–1.15) in Black women; Asian and other ethnic women had a significantly lower risk of all-cause and breast cancer-specific mortality.
Conclusions
There were substantial age and racial disparities in the prevalence of hypertension and diabetes and in the receipt of medications. Black women did not have a significantly higher risk of all-cause mortality but had a significantly higher risk of breast cancer-specific mortality as compared to White women.</description><identifier>ISSN: 2197-3792</identifier><identifier>EISSN: 2196-8837</identifier><identifier>DOI: 10.1007/s40615-022-01235-4</identifier><identifier>PMID: 35040106</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Age ; Aged ; Antihypertensives ; Black or African American ; Black people ; Breast cancer ; Breast Neoplasms ; Cancer therapies ; Chemotherapy ; Comorbidity ; Diabetes ; Diabetes mellitus ; Drugs ; Endocrine therapy ; Epidemiology ; Ethnicity ; Female ; Health disparities ; Health insurance ; Health maintenance organizations ; Healthcare Disparities ; HMOs ; Hormone replacement therapy ; Humans ; Hypertension ; Illnesses ; Inequality ; Mastectomy ; Medical diagnosis ; Medicare ; Medicine ; Medicine & Public Health ; Mortality ; Older people ; Older women ; Patients ; Quality of Life Research ; Race ; Race factors ; Racial differences ; Racial Groups ; Racial inequality ; Radiation ; Radiation therapy ; Risk ; Social Inequality ; Social Structure ; Sociodemographics ; Surveillance ; Tumors ; United States - epidemiology ; Variables ; White People ; Womens health</subject><ispartof>Journal of racial and ethnic health disparities, 2023-02, Vol.10 (1), p.446-461</ispartof><rights>W. Montague Cobb-NMA Health Institute 2022</rights><rights>2022. W. Montague Cobb-NMA Health Institute.</rights><rights>W. Montague Cobb-NMA Health Institute 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c431t-2033adc460b6d46daaa884c37ae5f37c31a1ce5a8080dff2c47d366c8133d0903</citedby><cites>FETCH-LOGICAL-c431t-2033adc460b6d46daaa884c37ae5f37c31a1ce5a8080dff2c47d366c8133d0903</cites><orcidid>0000-0003-0119-5252</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40615-022-01235-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2922079636?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,780,784,885,12740,12819,12846,21388,21389,21391,27924,27925,30999,33530,33744,34005,35805,35810,41488,42557,43659,43805,43953,44329,44330,51319,64385,64389,72469</link.rule.ids><linktorsrc>$$Uhttps://www.proquest.com/docview/2922079636?pq-origsite=primo$$EView_record_in_ProQuest$$FView_record_in_$$GProQuest</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35040106$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Du, Xianglin L.</creatorcontrib><creatorcontrib>Song, Lulu</creatorcontrib><title>Age and Racial Disparities in the Utilization of Anticancer, Antihypertension, and Anti-diabetes Therapies, and in Mortality in a Large Population-Based Cohort of Older Women with Breast Cancer</title><title>Journal of racial and ethnic health disparities</title><addtitle>J. Racial and Ethnic Health Disparities</addtitle><addtitle>J Racial Ethn Health Disparities</addtitle><description>Objective
This study examined the receipt of therapies for cancer, hypertension, and diabetes in association with age and racial disparities in mortality among women with breast cancer.
Methods
This study identified 92,829 women diagnosed with breast cancer at age ≥ 65 years in 2007–2015 with follow-up to 2016 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database.
Results
There were substantial age and racial disparities in the prevalence of hypertension and diabetes, which was higher in women ≥ 75 (86.3% and 32.0%) than younger women 65–74 (72.8% and 29.3%), and the highest in Black women (91.1% and 49.1%), followed by Asian women (80.2% and 40.5%), and White women (77.6 and 27.8%). Black women were significantly less likely to receive chemotherapy (odds ratio: 0.70, 95% CI: 0.64–0.75), radiation therapy (0.87, 0.83–0.92), and hormone therapy (0.80, 0.76–0.85), but significantly more likely to receive antihypertensive (1.26, 1.19–1.33) and antidiabetic (1.19, 1.10–1.28) drugs than White women, after adjusting for sociodemographic and tumor factors. As compared to White women, Black women had a significantly higher risk of all-cause mortality (1.46, 1.41–1.52), but it became insignificant after adjusting for treatment factors (1.01, 0.97–1.06), whereas the adjusted risk of breast cancer-specific mortality remained significantly higher (1.08, 1.01–1.15) in Black women; Asian and other ethnic women had a significantly lower risk of all-cause and breast cancer-specific mortality.
Conclusions
There were substantial age and racial disparities in the prevalence of hypertension and diabetes and in the receipt of medications. Black women did not have a significantly higher risk of all-cause mortality but had a significantly higher risk of breast cancer-specific mortality as compared to White women.</description><subject>Age</subject><subject>Aged</subject><subject>Antihypertensives</subject><subject>Black or African American</subject><subject>Black people</subject><subject>Breast cancer</subject><subject>Breast Neoplasms</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Comorbidity</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Drugs</subject><subject>Endocrine therapy</subject><subject>Epidemiology</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Health disparities</subject><subject>Health insurance</subject><subject>Health maintenance organizations</subject><subject>Healthcare Disparities</subject><subject>HMOs</subject><subject>Hormone replacement therapy</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Illnesses</subject><subject>Inequality</subject><subject>Mastectomy</subject><subject>Medical diagnosis</subject><subject>Medicare</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Older people</subject><subject>Older women</subject><subject>Patients</subject><subject>Quality of Life Research</subject><subject>Race</subject><subject>Race factors</subject><subject>Racial differences</subject><subject>Racial Groups</subject><subject>Racial inequality</subject><subject>Radiation</subject><subject>Radiation therapy</subject><subject>Risk</subject><subject>Social Inequality</subject><subject>Social Structure</subject><subject>Sociodemographics</subject><subject>Surveillance</subject><subject>Tumors</subject><subject>United States - epidemiology</subject><subject>Variables</subject><subject>White People</subject><subject>Womens health</subject><issn>2197-3792</issn><issn>2196-8837</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>LD-</sourceid><sourceid>LD.</sourceid><sourceid>QXPDG</sourceid><recordid>eNp9kc1u1DAUhSMEolXpC7BAltg24J_ESVZoOvxKg4pQK5bWHftm4ipjB9sDGt6ON8OTKQU2rHztc_ydK52ieMroC0Zp8zJWVLK6pJyXlHFRl9WD4pSzTpZtK5qH89yUoun4SXEe4y2l2VbXnZCPixNR04oyKk-Ln4sNEnCGfAZtYSSvbZwg2GQxEutIGpDcJDvaH5Csd8T3ZOGS1eA0hot5HvYThoQuZv1iRh1eS2NhjSlTrgcMMGXeUczQjz4kGG3aHy5AVhDyDp_8tBvnkPISIhqy9EP2HRKvRoOBfPFbdOS7TQO5DAgxkeW8xZPiUQ9jxPO786y4efvmevm-XF29-7BcrEpdCZZKToUAoytJ19JU0gBA21ZaNIB1LxotGDCNNbS0pabvua4aI6TULRPC0I6Ks-LVkTvt1ls0Gl0KMKop2C2EvfJg1b-Ks4Pa-G-K0YYz0daZ8PyOEPzXHcakbv0uuLy04h3ntOmkkNnFjy4dfIwB-_sIRtWhenWsXuXq1Vy9qvKnZ38vd__ld9HZII6GmCW3wfAn-z_YX2azvJo</recordid><startdate>20230201</startdate><enddate>20230201</enddate><creator>Du, Xianglin L.</creator><creator>Song, Lulu</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>LD-</scope><scope>LD.</scope><scope>M0S</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PATMY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PYCSY</scope><scope>QXPDG</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0119-5252</orcidid></search><sort><creationdate>20230201</creationdate><title>Age and Racial Disparities in the Utilization of Anticancer, Antihypertension, and Anti-diabetes Therapies, and in Mortality in a Large Population-Based Cohort of Older Women with Breast Cancer</title><author>Du, Xianglin L. ; Song, Lulu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c431t-2033adc460b6d46daaa884c37ae5f37c31a1ce5a8080dff2c47d366c8133d0903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Age</topic><topic>Aged</topic><topic>Antihypertensives</topic><topic>Black or African American</topic><topic>Black people</topic><topic>Breast cancer</topic><topic>Breast Neoplasms</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Comorbidity</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Drugs</topic><topic>Endocrine therapy</topic><topic>Epidemiology</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Health disparities</topic><topic>Health insurance</topic><topic>Health maintenance organizations</topic><topic>Healthcare Disparities</topic><topic>HMOs</topic><topic>Hormone replacement therapy</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Illnesses</topic><topic>Inequality</topic><topic>Mastectomy</topic><topic>Medical diagnosis</topic><topic>Medicare</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Older people</topic><topic>Older women</topic><topic>Patients</topic><topic>Quality of Life Research</topic><topic>Race</topic><topic>Race factors</topic><topic>Racial differences</topic><topic>Racial Groups</topic><topic>Racial inequality</topic><topic>Radiation</topic><topic>Radiation therapy</topic><topic>Risk</topic><topic>Social Inequality</topic><topic>Social Structure</topic><topic>Sociodemographics</topic><topic>Surveillance</topic><topic>Tumors</topic><topic>United States - epidemiology</topic><topic>Variables</topic><topic>White People</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Du, Xianglin L.</creatorcontrib><creatorcontrib>Song, Lulu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Ethnic NewsWatch</collection><collection>Ethnic NewsWatch (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Sociology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Environmental Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Environmental Science Collection</collection><collection>Diversity Collection</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of racial and ethnic health disparities</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Du, Xianglin L.</au><au>Song, Lulu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Age and Racial Disparities in the Utilization of Anticancer, Antihypertension, and Anti-diabetes Therapies, and in Mortality in a Large Population-Based Cohort of Older Women with Breast Cancer</atitle><jtitle>Journal of racial and ethnic health disparities</jtitle><stitle>J. Racial and Ethnic Health Disparities</stitle><addtitle>J Racial Ethn Health Disparities</addtitle><date>2023-02-01</date><risdate>2023</risdate><volume>10</volume><issue>1</issue><spage>446</spage><epage>461</epage><pages>446-461</pages><issn>2197-3792</issn><eissn>2196-8837</eissn><abstract>Objective
This study examined the receipt of therapies for cancer, hypertension, and diabetes in association with age and racial disparities in mortality among women with breast cancer.
Methods
This study identified 92,829 women diagnosed with breast cancer at age ≥ 65 years in 2007–2015 with follow-up to 2016 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database.
Results
There were substantial age and racial disparities in the prevalence of hypertension and diabetes, which was higher in women ≥ 75 (86.3% and 32.0%) than younger women 65–74 (72.8% and 29.3%), and the highest in Black women (91.1% and 49.1%), followed by Asian women (80.2% and 40.5%), and White women (77.6 and 27.8%). Black women were significantly less likely to receive chemotherapy (odds ratio: 0.70, 95% CI: 0.64–0.75), radiation therapy (0.87, 0.83–0.92), and hormone therapy (0.80, 0.76–0.85), but significantly more likely to receive antihypertensive (1.26, 1.19–1.33) and antidiabetic (1.19, 1.10–1.28) drugs than White women, after adjusting for sociodemographic and tumor factors. As compared to White women, Black women had a significantly higher risk of all-cause mortality (1.46, 1.41–1.52), but it became insignificant after adjusting for treatment factors (1.01, 0.97–1.06), whereas the adjusted risk of breast cancer-specific mortality remained significantly higher (1.08, 1.01–1.15) in Black women; Asian and other ethnic women had a significantly lower risk of all-cause and breast cancer-specific mortality.
Conclusions
There were substantial age and racial disparities in the prevalence of hypertension and diabetes and in the receipt of medications. Black women did not have a significantly higher risk of all-cause mortality but had a significantly higher risk of breast cancer-specific mortality as compared to White women.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>35040106</pmid><doi>10.1007/s40615-022-01235-4</doi><tpages>16</tpages><orcidid>https://orcid.org/0000-0003-0119-5252</orcidid></addata></record> |
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| ispartof | Journal of racial and ethnic health disparities, 2023-02, Vol.10 (1), p.446-461 |
| issn | 2197-3792 2196-8837 |
| language | eng |
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| source | Ethnic NewsWatch (Alumni) |
| subjects | Age Aged Antihypertensives Black or African American Black people Breast cancer Breast Neoplasms Cancer therapies Chemotherapy Comorbidity Diabetes Diabetes mellitus Drugs Endocrine therapy Epidemiology Ethnicity Female Health disparities Health insurance Health maintenance organizations Healthcare Disparities HMOs Hormone replacement therapy Humans Hypertension Illnesses Inequality Mastectomy Medical diagnosis Medicare Medicine Medicine & Public Health Mortality Older people Older women Patients Quality of Life Research Race Race factors Racial differences Racial Groups Racial inequality Radiation Radiation therapy Risk Social Inequality Social Structure Sociodemographics Surveillance Tumors United States - epidemiology Variables White People Womens health |
| title | Age and Racial Disparities in the Utilization of Anticancer, Antihypertension, and Anti-diabetes Therapies, and in Mortality in a Large Population-Based Cohort of Older Women with Breast Cancer |
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