Tomi F Akinyemiju1, Neomi Vin-Raviv2, Daniel Chavez-Yenter3, Xueyan Zhao4, Henna Budhwani3. 1. Department of Epidemiology, University of Alabama at Birmingham, Birmingham AL, United States. Electronic address: tomiakin@uab.edu. 2. Rocky Mountain Cancer Rehabilitation Institute, School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO, United States. 3. Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham AL, United States. 4. Department of Epidemiology, University of Alabama at Birmingham, Birmingham AL, United States.
Abstract
BACKGROUND: The purpose of this study is to evaluate racial and socio-economic differences in breast cancer surgery treatment, post-surgical complications, hospital length of stay and mortality among hospitalized breast cancer patients. METHODS: We examined the association between race/ethnicity and socio-economic status with treatment and outcomes after surgery among 71,156 women hospitalized with a primary diagnosis of breast cancer using the Nationwide Inpatient Sample database from 2007 to 2011. Multivariable regression models were used to compute estimates, odds ratios and 95% confidence intervals adjusting for age, comorbidities, stage at diagnosis, insurance, and residential region. RESULTS: Black women were more likely to receive breast conserving surgery but less likely to receive mastectomies compared with white women. They also experienced significantly longer hospital stays (β=0.31, 95% CI: 0.24, 0.39), post-surgical complications (OR=1.21, 95% CI: 1.04-1.42) and in-hospital mortality (OR=1.26, 95% CI: 1.07-1.50) compared with Whites, after adjusting for other factors including the number of comorbidities and treatment type. CONCLUSION: Among patients hospitalized for breast cancer, there were racial differences observed in treatment and outcomes. Further studies are needed to fully characterize whether these differences are due to individual, provider level or hospital level factors, and to highlight areas for targeted approaches to eliminate these disparities.
BACKGROUND: The purpose of this study is to evaluate racial and socio-economic differences in breast cancer surgery treatment, post-surgical complications, hospital length of stay and mortality among hospitalized breast cancerpatients. METHODS: We examined the association between race/ethnicity and socio-economic status with treatment and outcomes after surgery among 71,156 women hospitalized with a primary diagnosis of breast cancer using the Nationwide Inpatient Sample database from 2007 to 2011. Multivariable regression models were used to compute estimates, odds ratios and 95% confidence intervals adjusting for age, comorbidities, stage at diagnosis, insurance, and residential region. RESULTS: Black women were more likely to receive breast conserving surgery but less likely to receive mastectomies compared with white women. They also experienced significantly longer hospital stays (β=0.31, 95% CI: 0.24, 0.39), post-surgical complications (OR=1.21, 95% CI: 1.04-1.42) and in-hospital mortality (OR=1.26, 95% CI: 1.07-1.50) compared with Whites, after adjusting for other factors including the number of comorbidities and treatment type. CONCLUSION: Among patients hospitalized for breast cancer, there were racial differences observed in treatment and outcomes. Further studies are needed to fully characterize whether these differences are due to individual, provider level or hospital level factors, and to highlight areas for targeted approaches to eliminate these disparities.
Authors: Justin G Trogdon; Donatus U Ekwueme; Diana Poehler; Cheryll C Thomas; Katherine Reeder-Hayes; Benjamin T Allaire Journal: Breast Cancer Res Treat Date: 2017-07-12 Impact factor: 4.872
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Authors: Tomi Akinyemiju; Justin Xavier Moore; Akinyemi I Ojesina; John W Waterbor; Sean F Altekruse Journal: Breast Cancer Res Treat Date: 2016-06-02 Impact factor: 4.872
Authors: Justin Xavier Moore; Tomi Akinyemiju; Alfred Bartolucci; Henry E Wang; John Waterbor; Russell Griffin Journal: Cancer Epidemiol Date: 2018-05-25 Impact factor: 2.984
Authors: Justin Xavier Moore; Kendra J Royston; Marvin E Langston; Russell Griffin; Bertha Hidalgo; Henry E Wang; Graham Colditz; Tomi Akinyemiju Journal: Cancer Causes Control Date: 2018-06-19 Impact factor: 2.506
Authors: Justin Xavier Moore; Tomi Akinyemiju; Alfred Bartolucci; Henry E Wang; John Waterbor; Russell Griffin Journal: J Intensive Care Med Date: 2018-06-03 Impact factor: 3.510