ArticleBreast cancer research and treatment2024
Racialized economic segregation and inequities in treatment initiation and survival among patients with metastatic breast cancer.
Article in Breast cancer research and treatment, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Structural racism as a leading cause of racial disparities in breast cancer quality of care outcomes: a systematic review.Frontiers in oncology · 2025Pooled it
- Article
- Tumor biology and access to care and metastatic breast cancer outcomes.Breast cancer research and treatment · 2025Article
- Assessing equity of care across metastatic breast cancer treatment junctures: a multi-site retrospective cohort study.BMC cancer · 2025Article
- Racial and Ethnic Disparities in Receipt of ERBB2-Targeted Therapy for Breast Cancer, 2010-2020.JAMA network open · 2025Article
- Characterisation of oncology EHR-derived real-world data in the UK, Germany, and Japan.ESMO real world data and digital oncology · 2025Review
- Immediate implant-based breast reconstruction following mastectomy is not associated with delays in adjuvant therapy.Frontiers in oncology · 2025Article
- Structural racism and inequity in cancer clinical trial participation: time for solutions.JNCI cancer spectrum · 2024Article
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Abstract
purposeRacialized economic segregation, a form of structural racism, may drive persistent inequities among patients with breast cancer. We examined whether a composite area-level index of racialized economic segregation was associated with real-world treatment and survival in metastatic breast cancer (mBC).
methodsWe conducted a retrospective cohort study among adult women with mBC using a US nationwide electronic health record-derived de-identified database (2011-2022). Population-weighted quintiles of the index of concentration at the extremes were estimated using census tract data. To identify inequities in time to treatment initiation (TTI) and overall survival (OS), we employed Kaplan-Meier methods and estimated hazard ratios (HR) adjusted for clinical factors.
resultsThe cohort included 27,459 patients. Compared with patients from the most privileged areas, those from the least privileged areas were disproportionately Black (36.9% vs. 2.6%) or Latinx (13.2% vs. 2.6%) and increasingly diagnosed with de novo mBC (33.6% vs. 28.9%). Those from the least privileged areas had longer median TTI than those from the most privileged areas (38 vs 31 days) and shorter median OS (29.7 vs 39.2 months). Multivariable-adjusted HR indicated less timely treatment initiation (HR 0.87, 95% CI 0.83, 0.91, p < 0.01) and worse OS (HR 1.19, 95% CI 1.13, 1.25, p < 0.01) among those from the least privileged areas compared to the most privileged areas.
conclusionRacialized economic segregation is a social determinant of health associated with treatment and survival inequities in mBC. Public investments directly addressing racialized economic segregation and other forms of structural racism are needed to reduce inequities in cancer care and outcomes.
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