ArticleBMC cancer2015
Representativeness of breast cancer cases in an integrated health care delivery system.
Article in BMC cancer, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Sociodemographic Disparities in Oncology Clinical Trial Enrollment in an Integrated Health System.JAMA network open · 2026Article
- Clinician- and facility-level factors associated with chemotherapy dose reductions in stages I-IIIA breast cancer.Journal of the National Cancer Institute · 2026Article
- Clinically Meaningful, Patient-Centered Endpoints for Real-World Evidence Generation in Breast Cancer: Perspectives from the Multidisciplinary TRIUMPH Initiative.Advances in therapy · 2026Article
- Non-believer to Believer: A Podcast Conversation on the Journey from Skeptic to Proponent of Oncology Real-World Evidence.Oncology and therapy · 2025Article
- Availability of sexual orientation and gender identity (SOGI) information in a cohort of transgender and gender diverse people: An analysis of electronic health records.Annals of epidemiology · 2025Article
- Beyond the 5-year mark: adherence to and continuation of extended adjuvant endocrine therapy in non-metastatic breast cancer patients.Breast cancer research and treatment · 2025Article
- Understanding the association between body mass index and chemotherapy dose reductions in women treated for stage I-IIIA breast cancer.NPJ breast cancer · 2025Article
- Trastuzumab therapy and new-onset hypertension in adolescents and young adults with breast cancer.Breast cancer research and treatment · 2025Article
- Evaluating the role of palliative care in emergency department opioid use among advanced cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Telehealth and Health Care Contact Days Among Patients With Advanced Cancer After COVID-19.JAMA network open · 2025Article
- Association between neighborhood stressors and allostatic load in breast cancer survivors: the Pathways Study.American journal of epidemiology · 2025Article
- The landscape of use of NCCN-guideline chemotherapy regimens in stage I-IIIA breast cancer in an integrated healthcare delivery system.Breast cancer research and treatment · 2024Article
- Patient characteristics associated with delayed time to adjuvant chemotherapy among women treated for stage I-IIIA breast cancer.International journal of cancer · 2024Article
- Representativeness of Patients With Lung Cancer in an Integrated Health Care Delivery System.The Permanente journal · 2024Observational
- Trends in chemotherapy use for early-stage breast cancer from 2006 to 2019.Breast cancer research : BCR · 2024Article
- Differences in Smoking Behavior by Nativity, Race/Ethnicity, and Education among Women Diagnosed with Breast Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024Article
- Sociodemographic Inequities in Telemedicine Use Among US Patients Initiating Treatment in Community Cancer Centers During the Ongoing COVID-19 Pandemic, 2020-2022.JCO oncology practice · 2023Article
- Hypothetical Interventions on Diet Quality and Lifestyle Factors to Improve Breast Cancer Survival: The Pathways Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2023Article
- Integrating Electronic Health Record, Cancer Registry, and Geospatial Data to Study Lung Cancer in Asian American, Native Hawaiian, and Pacific Islander Ethnic Groups.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2021Article
- Population-Based Registry Linkages to Improve Validity of Electronic Health Record-Based Cancer Research.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2020Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundIntegrated health care delivery systems, with their comprehensive and integrated electronic medical records (EMR), are well-poised to conduct research that leverages the detailed clinical data within the EMRs. However, information regarding the representativeness of these clinical populations is limited, and thus the generalizability of research findings is uncertain.
methodsUsing data from the population-based California Cancer Registry, we compared age-adjusted distributions of patient and neighborhood characteristics for three groups of breast cancer patients: 1) those diagnosed within Kaiser Permanente Northern California (KPNC), 2) non-KPNC patients from NCI-designated cancer centers, and 3) those from all other hospitals.
resultsKPNC patients represented 32 % (N = 36,109); cancer center patients represented 7 % (N = 7805); and all other hospitals represented 61 % (N = 68,330) of the total breast cancer patients from this geographic area during 1996-2009. Compared with cases from all other hospitals, KPNC had slightly fewer non-Hispanic Whites (70.6 % versus 74.4 %) but more Blacks (8.1 % versus 5.0 %), slightly more patients in the 50-69 age range and fewer in the younger and older age groups, a slightly lower proportion of in situ but higher proportion of stage I disease (41.6 % versus 38.9 %), were slightly less likely to reside in the lowest (4.2 % versus 6.5 %) and highest (36.2 % versus 39.0 %) socioeconomic status neighborhoods, and more likely to live in suburban metropolitan areas and neighborhoods with more racial/ethnic minorities. Cancer center patients differed substantially from patients from KPNC and all other hospitals on all characteristics assessed. All differences were statistically significant (p < .001).
conclusionsAlthough much of clinical research discoveries are based in academic medical centers, patients from large, integrated medical centers are likely more representative of the underlying population, providing support for the generalizability of cancer research based on electronic data from these centers.
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