ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2019
Multilevel Examination of Health Disparity: The Role of Policy Implementation in Neighborhood Context, in Patient Resources, and in Healthcare Facilities on Later Stage of Breast Cancer Diagnosis.
Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
What it found
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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
38 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review of neighborhood socioeconomic indices studied across the cancer control continuum.Cancer medicine · 2022Pooled it
- Examining the Role of the Social Vulnerability Index in the Association between Race/Ethnicity and Breast Cancer Outcomes.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Article
- Characterizing Social Determinants of Health in Patients With Type 2 Diabetes and Liver Disease: Cross-Sectional Survey Study.JMIR formative research · 2026Article
- Strategies for sustainable lung cancer screening: a multi-faceted perspective to long-term surveillance in SOLACE.Insights into imaging · 2026Article
- Solution-Based Research to Address Disparities in Precision Cancer Health: A Case Report Elucidating the Design and Rationale of the Illinois Cancer Health Equity Research (I-CHER) Center.International journal of environmental research and public health · 2026Article
- Low Socioeconomic Status at the Patient and Institutional Level Impact Achievement of Breast Cancer Quality Standards.Annals of surgical oncology · 2025Article
- Ethnic enclaves, neighborhood socioeconomic status, and obesity among Hispanic women in Chicago: a latent profile analysis approach.Cancer causes & control : CCC · 2025Article
- Review
- Identifying Frequently Endorsed Benefits and Barriers to Breast Cancer Screening for African-Born Women in the NYC Metropolitan Area: a Pilot Study.Journal of racial and ethnic health disparities · 2025Article
- Evaluating the intersection of climate vulnerability and cancer burden in North Carolina.JNCI cancer spectrum · 2025Article
- Cancer outcomes and cardiopulmonary toxicities for Black patients with breast cancer treated with proton therapy.JNCI cancer spectrum · 2025Article
- Triple-Negative Breast Cancer on the Rise: Breakthroughs and Beyond.Breast cancer (Dove Medical Press) · 2025Review
- Multilevel contributors to racial and ethnic inequities in the resolution of abnormal mammography results.Cancer causes & control : CCC · 2024Article
- Ethnic disparities in breast cancer patterns in Brazil: examining findings from population-based registries.Breast cancer research and treatment · 2024Article
- Cancer health awareness through screening and education: A community approach to healthy equity.Cancer medicine · 2024Article
- Equity in Cancer and Chronic Disease Prevention through a Multi-Pronged Network Intervention: Works-in-Progress.International journal of environmental research and public health · 2024Article
- A catchment and location-allocation analysis of mammography access in Delaware, US: implications for disparities in geographic access to breast cancer screening.Breast cancer research : BCR · 2023Article
- The Integration of Value Assessment and Social Network Methods for Breast Health Navigation Among African Americans.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2023Article
- Neighborhood factors and triple negative breast cancer: The role of cumulative exposure to area-level risk factors.Cancer medicine · 2023Article
- A Catchment and Location-Allocation Analysis of Mammography Access in Delaware, US: Implications for disparities in geographic access to breast cancer screening.Research square · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundThere is a substantial racial/ethnic disparity in female breast cancer mortality in Chicago between non-Hispanic black (NHblack) and Hispanic patients compared with their non-Hispanic white (NHwhite) counterparts. This observation prompted a multilevel examination of factors that might account for the disparity, with the goal of identifying potential policy interventions that might meaningfully address it
methodsIn the Breast Cancer Care in Chicago study, 411 NHblack, 397 NHwhite, and 181 Hispanic patients diagnosed between the ages of 30 and 79 were interviewed, and medical records were abstracted for information on screening and diagnostic follow-up. We conducted a multilevel analysis to assess the role of neighborhood context, patient resources, facility characteristics, and mode of detection in determining the disparity in later stage at diagnosis.
resultsAfter adjustment for neighborhood context, mode of detection, and facility accreditation/resources, there was no significant disparity in later stage breast cancer diagnosis between NHblack or Hispanic patients compared with NHwhite patients.
conclusionsThe results suggest that racial/ethnic differences in mode of detection and facility accreditation/resources account for most of the disparity in stage at diagnosis. Understanding the causes of differential screen detection and access to highly accredited facilities could inform interventions to meaningfully address this disparity. IMPACT: Multilevel approaches to studying health disparities are becoming the research standard for understanding and addressing health disparities. Optimal design of multilevel interventions addressing disparities in later stage diagnosis would benefit from enhanced understanding of pathways to detection and diagnosis available to patients in medically underserved communities.
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