ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2015
Household net worth, racial disparities, and hormonal therapy adherence among women with early-stage breast cancer.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 2 of them syntheses that pooled it.
What it found
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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
79 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Cost-sharing and adherence, clinical outcomes, health care utilization, and costs: A systematic literature review.Journal of managed care & specialty pharmacy · 2023Pooled it
- A systematic review of interventions to improve adherence to endocrine therapy.Breast cancer research and treatment · 2019Pooled it
- Impact of adding palbociclib on treatment adherence to ongoing adjuvant endocrine treatment in the global randomized PALLAS randomized trial in patients with early breast cancer.Breast cancer research and treatment · 2025Trial
- Race and clinical outcomes in hormone receptor-positive, HER2-negative, node-positive breast cancer in the randomized RxPONDER trial.Journal of the National Cancer Institute · 2025Trial
- Use of a web-based app to improve breast cancer symptom management and adherence for aromatase inhibitors: a randomized controlled feasibility trial.Journal of cancer survivorship : research and practice · 2018Trial
- Prognostic consistency of oncotype DX® molecular assay across racial groups in early-stage hormone receptor-positive breast cancer.NPJ breast cancer · 2026Article
- Comparing endocrine therapy adherence across EHR and claims data by race and ethnicity, language, and insurance.Cancer causes & control : CCC · 2026Article
- Sexual dysfunction in Brazilian women undergoing adjuvant endocrine therapy for breast cancer: prevalence and associated factors.Scientific reports · 2026Article
- Guideline-concordance along the cancer care continuum and breast cancer mortality by race and ethnicity: a SEER-Medicare study.Cancer causes & control : CCC · 2026Article
- Hidden Costs of Endocrine Therapy for Black Breast Cancer Survivors: A Qualitative Examination of Patient and Provider Experiences.Clinical breast cancer · 2025Article
- Barriers to endocrine therapy adherence: perspectives of Black breast cancer survivors and their providers.Journal of cancer survivorship : research and practice · 2025Article
- The association of distress and depression screening measures and other electronic health record information with adjuvant endocrine therapy persistence.Breast cancer research and treatment · 2025Article
- Group-Based Trajectory Modeling to Identify Patterns and Predictors of Adherence to Oral Endocrine Therapies in Underserved Population of Greater Houston Area.Patient preference and adherence · 2025Article
- Racial discrimination and health-care system trust among American adults with and without cancer.Journal of the National Cancer Institute · 2024Article
- Racial Disparity in Adherence to Endocrine Therapy among Women with Early-Stage Hormone Receptor Positive Breast Cancer: An Analysis of Arkansas All-Payers Claims Database.Clinical breast cancer · 2024Article
- Disparities in Overall Survival Rates for Cancers across Income Levels in the Republic of Korea.Cancers · 2024Article
- Ten-Year Trend of Oral Anticoagulation Use in Postoperative and Nonpostoperative Atrial Fibrillation in Routine Clinical Practice.Journal of the American Heart Association · 2024Article
- Guideline-concordant breast cancer care by patient race and ethnicity accounting for individual-, facility- and area-level characteristics: a SEER-Medicare study.Cancer causes & control : CCC · 2024Article
- Familial adversity: association with discontinuation of adjuvant hormone therapy and breast cancer prognosis.Journal of the National Cancer Institute · 2024Article
- Investigation of Factors Affecting Adherence to Adjuvant Hormone Therapy in Early-Stage Breast Cancer Patients: A Comprehensive Systematic Review.Journal of breast cancer · 2023Article
19 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
purposeNonadherence to adjuvant hormonal therapy is common and is associated with increased prescription copayment amount and black race. Studies suggest that household wealth may partly explain racial disparities. We investigated the impact of net worth on disparities in adherence and discontinuation. PATIENTS AND
methodsWe used the OptumInsight insurance claims database to identify women older than age 50 years diagnosed with early breast cancer, from January 1, 2007, to December 31, 2011, who were using hormonal therapy. Nonadherence was defined as a medication possession ratio of ≤ 80% of eligible days over a 2-year period. We evaluated the association of demographic and clinical characteristics, annual household income, household net worth (< $250,000, $250,000 to $750,000, or > $750,000), insurance type, and copayments (< $10, $10 to $20, or > $20) with adherence to hormonal therapy. Logistic regression analyses were conducted by sequentially adding sociodemographic and financial variables to race.
resultsWe identified 10,302 patients; 2,473 (24%) were nonadherent. In the unadjusted analyses, adherence was negatively associated with black race (odds ratio [OR], 0.76; P < .001), advanced age, comorbidity, and Medicare insurance. Adherence was positively associated with medium (OR, 1.33; P < .001) and high (OR, 1.66; P < .001) compared with low net worth. The negative association of black race with adherence (OR, 0.76) was reduced by adding net worth to the model (OR, 0.84; P < .05). Correcting for other variables had a minimal impact on the association between race and adherence (OR, 0.87; P = .08). The interaction between net worth and race was significant (P < .01).
conclusionWe found that net worth partially explains racial disparities in hormonal therapy adherence. These results suggest that economic factors may contribute to disparities in the quality of care.
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