ArticleCancer2021
Initiation and adherence to adjuvant endocrine therapy among urban, insured American Indian/Alaska Native breast cancer survivors.
Article in Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Utilisation of endocrine therapy for cancer in Indigenous peoples: a systematic review and meta-analysis.BMC cancer · 2024Pooled it
- Immigration and Social Factors, Tumor Stage, and Risk of Contralateral Breast Cancer in Asian American and Hispanic Women.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Article
- Hidden in the Data: Breast Cancer Patterns, Gaps, and Challenges for Native American Women.Current breast cancer reports · 2026Review
- High Adherence to Adjuvant Endocrine Therapy Improves Outcome in Early Breast Cancer - Results from a Large Real-World Claims Data Analysis in Germany.Geburtshilfe und Frauenheilkunde · 2026Article
- Improving adjuvant endocrine therapy initiation among patients with breast cancer: a nurse-led, culturally sensitive pilot study.Breast cancer research and treatment · 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
- Concurrent factors associated with adherence to adjuvant endocrine therapy among women with non-metastatic breast cancer.Journal of cancer survivorship : research and practice · 2025Article
- Influencing Factors of Adherence to Adjuvant Endocrine Therapy in Breast Cancer Patients: A Meta-Analysis.Health science reports · 2025Review
- Racial Disparities in Breast Cancer: from Detection to Treatment.Current oncology reports · 2024Review
- Disparities in stage at diagnosis among breast cancer molecular subtypes in China.Cancer medicine · 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
- Predictors of adherence and the role of primary non-adherence in antihormonal treatment of breast cancer.BMC cancer · 2022Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundIt has been shown that racial/ethnic disparities exist with regard to initiation of and adherence to adjuvant endocrine therapy (AET). However, the relationship among American Indian/Alaska Native (AIAN) individuals is poorly understood, particularly among those who reside in urban areas. We evaluated whether AET initiation and adherence were lower among AIAN individuals than those of other races/ethnicities who were enrolled in the Kaiser Permanente of Northern California (KPNC) health system.
methodsWe identified 23,680 patients from the period 1997 to 2014 who were eligible for AET (first primary, stage I-III, hormone receptor-positive breast cancer) and used KPNC pharmacy records to identify AET prescriptions and refill dates. We assessed AET initiation (≥1 filled prescription within 1 year of diagnosis) and AET adherence (proportion of days covered ≥80%) every year up to 5 years after AET initiation.
resultsAt the end of the 5-year follow-up period, 83% of patients were AET initiators, and 58% were AET adherent. Compared with other races/ethnicities, AIAN women had the second-lowest rate of AET initiation (non-Hispanic Black [NHB], 78.0%; AIAN, 78.6%; Hispanic, 83.0%; non-Hispanic White [NHW], 82.5%; Asian/Pacific Islander [API], 84.7%), the lowest rate of AET adherence after 1 year and 5 years of follow-up (70.3% and 50.8%, respectively), and the greatest annual decline in AET adherence during the 4- to 5-year period of follow-up (a 13.8% decrease in AET adherence [from 64.6% to 50.8%]) after initiation of AET. In adjusted multivariable models, AIAN, Hispanic, and NHB women were less likely than NHW women to be AET adherent. At the end of the 5-year period, total underutilization (combining initiation and adherence) in AET-eligible patients was greatest among AIAN (70.6%) patients, followed by NHB (69.6%), Hispanic (63.2%), NHW (58.7%), and API (52.3%) patients, underscoring the AET treatment gap.
conclusionOur results suggest that AET initiation and adherence are particularly low for insured AIAN women.
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