ArticleAnnals of surgical oncology2011
Socioeconomic and racial differences in treatment for breast cancer at a low-volume hospital.
Article in Annals of surgical oncology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Variations in outcomes by residential location for women with breast cancer: a systematic review.BMJ open · 2018Pooled it
- Healthcare facility volume and evidence-based practice implementation in surgical care of patients with common cancers.American journal of surgery · 2026Article
- Racial or Ethnic Disparities in Incidence, Treatment, and Prognosis of Adult Intracranial Meningiomas.Journal of racial and ethnic health disparities · 2025Article
- The intersection of travel burdens and financial hardship in cancer care: a scoping review.JNCI cancer spectrum · 2024Article
- Centralization of Initial Care and Improved Survival of Poor Patients With Breast Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- Geographic Variations and the Associated Factors in Adherence to and Persistence with Adjuvant Hormonal Therapy for the Privately Insured women Aged 18-64 with Breast Cancer in Texas.Current oncology (Toronto, Ont.) · 2023Article
- Rural-Urban Disparities in Cancer Outcomes: Opportunities for Future Research.Journal of the National Cancer Institute · 2022Review
- Invasive Breast Cancer Treatment Patterns in Women Age 80 and Over: A Report from the National Cancer Database.Clinical breast cancer · 2022Article
- The Intersection of Rural Residence and Minority Race/Ethnicity in Cancer Disparities in the United States.International journal of environmental research and public health · 2021Review
- Article
- Geographical Inequalities in Surgical Treatment for Localized Female Breast Cancer, Queensland, Australia 1997-2011: Improvements over Time but Inequalities Remain.International journal of environmental research and public health · 2016Article
- Reexamining the Relationship of Breast Cancer Hospital and Surgical Volume to Mortality: An Instrumental Variable Analysis.Medical care · 2015Observational
- Determinants of End-of-Life Expenditures in Patients with Oral Cancer in Taiwan: A Population-Based Study.PloS one · 2015Article
- Rural residence and cancer outcomes in the United States: issues and challenges.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2013Review
- Determinants of breast cancer treatment delay differ for African American and White women.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2013Article
- Carcinogenesis alters fatty acid profile in breast tissue.Molecular and cellular biochemistry · 2013Article
- The association of socioeconomic status and access to low-volume service providers in breast cancer.PloS one · 2013Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
purposePopulation-based studies have revealed higher mortality among breast cancer patients treated in low-volume hospitals. Other studies have demonstrated disparities in race and socioeconomic status (SES) in breast cancer survival. The purpose of our study was to determine whether nonwhite or low-SES patients are disproportionately treated in low-volume hospitals.
methodsA population-based cohort of 2,777 Medicare breast cancer patients who underwent breast cancer surgery in 2003 participated in a survey study examining breast cancer outcomes. Information was obtained from survey responses, Medicare claims, and state tumor registry data.
resultsOn univariate analysis, patients treated at low-volume hospitals were less likely to be white, less likely to live in an urban location, and more likely to have a low SES with less social support and live a greater distance from a high-volume hospital. Education, marital status, total household income, having additional insurance besides Medicare, population density of primary residence, and tangible support were associated with distance to the nearest high-volume hospital. On multivariate analysis, the independent predictors of treatment at a low-volume hospital were being nonwhite (P = 0.003), having a lower household income (P < 0.0001), residence in a rural location (P = 0.01), and living a greater distance from a high-volume hospital (P < 0.0001).
conclusionsIn this large population-based cohort, women who were poorer, nonwhite, and who lived in a rural location or at a greater distance from a high-volume hospital were more likely to be treated at low-volume hospitals. These differences may partially explain racial and SES disparities in breast cancer outcomes.
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