ArticleMedical care2016
Racial/Ethnic and Socioeconomic Differences in Colorectal and Breast Cancer Treatment Quality: The Role of Physician-level Variations in Care.
Article in Medical care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Racial Differences in Breast Cancer Survival Between Black and White Women According to Tumor Subtype: A Systematic Review and Meta-Analysis.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Pooled it
- Surgical Services for Breast Cancer Patients in Australia, is There a Gap for Aboriginal and/or Torres Strait Islander Women?World journal of surgery · 2022Pooled it
- Disparities in Surgical Access: A Systematic Literature Review, Conceptual Model, and Evidence Map.Journal of the American College of Surgeons · 2019Pooled it
- Guideline-concordance along the cancer care continuum and breast cancer mortality by race and ethnicity: a SEER-Medicare study.Cancer causes & control : CCC · 2026Article
- Outcomes Among Patients With Colon Cancer Living in Neighborhoods With Persistent Poverty.JAMA network open · 2026Article
- The association of contemporary mortgage lending bias and receipt of guideline-concordant systemic treatment among older women with breast cancer.Breast cancer research and treatment · 2025Article
- Referrals and Black-White Coronary Heart Disease Treatment Disparities: A Qualitative Study of Primary Care Physician Perspectives.Journal of general internal medicine · 2025Article
- Omission of multimodal therapy in older adults with high-risk breast cancer.Breast cancer research and treatment · 2025Article
- The influence of socio-economic status on the fulfilment of Saint-Gallen recommendations for early-stage breast cancer.Scientific reports · 2025Article
- Determinants and timing of lifestyle changes in postmenopausal breast cancer survivors: A longitudinal qualitative study.PloS one · 2025Article
- Healthcare Experiences Are Associated with Colorectal Cancer Mortality but only for Specific Racial Groups: a SEER-CAHPS Study.Journal of racial and ethnic health disparities · 2024Article
- Article
- 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
- Physician-level variation in axillary surgery in older adults with T1N0 hormone receptor-positive breast cancer: A retrospective population-based cohort study.Journal of geriatric oncology · 2024Article
- The segregation of physician networks providing care to black and white patients with heart disease: Concepts, measures, and empirical evaluation.Social science & medicine (1982) · 2024Article
- Inequalities in treatment among patients with colon and rectal cancer: a multistate survival model using data from England national cancer registry 2012-2016.British journal of cancer · 2024Article
- Patterns of Evidence-Based Care for the Diagnosis, Staging, and First-line Treatment of Breast Cancer by Race-Ethnicity: A SEER-Medicare Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2023Article
- Income-related disparities in Medicare advantage behavioral health care quality.Health services research · 2023Article
- Identifying the origin of socioeconomic disparities in outcomes of major elective operations.Surgery open science · 2023Article
- Impact of race-specific screening guideline on the uptake of colorectal cancer screening among young African Americans.Cancer medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundDespite a large body of research showing racial/ethnic and socioeconomic disparities in cancer treatment quality, the relative role of physician-level variations in care is unclear.
objectiveTo examine the effect of physicians on disparities in breast and colorectal cancer care. SUBJECTS: Linked SEER Medicare data were used to identify Medicare beneficiaries diagnosed with colorectal and breast cancer during 1995-2007 and their treating physicians. RESEARCH
designWe identified treating physicians from Medicare claims data. We measured the use of NIH guideline-recommended therapies from SEER and Medicare claims data, and used logistic models to examine the relationship between race/ethnicity, socioeconomic status, and cancer quality of care. We used physician fixed effects to account for between-physician variations in treatment.
resultsMinority and low socioeconomic status beneficiaries with breast and colorectal cancer were less likely to receive any recommended treatments as compared with whites. Overall, between-physician variation explained <20% of the total variation in quality of care. After accounting for between-physician differences, median household income explained 14.3%, 18.4%, and 13.2% of the variation in use of breast-conserving surgery, chemotherapy, and radiation for breast cancer, and 13.7%, 12.9%, and 12.6% of the within-physician variation in use of colorectal surgery, chemotherapy, and radiation for colorectal cancer, whereas race and ethnicity explained <2% of the within-physician variation in cancer care.
conclusionsBetween-physician variations partially explain racial disparities in cancer care. Residual within-physician disparities may be due to differences in patient-provider communication, patient preferences and treatment adherence, or unmeasured clinical severity.
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Registered trials
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