Evidence map›Paper›PMID 38809304›Full record

ArticleBreast cancer research and treatment2024

Does structural racism impact receipt of NCCN guideline-concordant breast cancer treatment?

Maya Lubarsky, Alexandra E Hernandez, Brianna L Collie, Ashly C Westrick, Cheyenne Thompson, Susan B Kesmodel, Neha Goel

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

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 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Article
  6. Review
  7. Review
  8. Review
  9. Institutional Costs of Guideline-Concordant Care Non-Receipt among Women with Breast Cancer.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Maya Lubarsky *University of Miami Miller School of Medicine, Miami, FL, USA.
Alexandra E Hernandez *Department of Surgery, Division of Surgical Oncology, University of Miami, Miami, FL, USA.
Brianna L CollieDepartment of Surgery, Division of Surgical Oncology, University of Miami, Miami, FL, USA.
Ashly C WestrickUniversity of Michigan School of Public Health, Ann Arbor, MI, USA.
Cheyenne ThompsonDepartment of Surgery, Division of Surgical Oncology, University of Miami, Miami, FL, USA.
Susan B KesmodelDepartment of Surgery, Division of Surgical Oncology, University of Miami, Miami, FL, USA.
Neha GoelDepartment of Surgery, Division of Surgical Oncology, University of Miami, Miami, FL, USA. neha.goel@med.miami.edu.

Funding

American Surgical Association Foundation American Surgical Association Fellowship Award, American Society of Clinical Oncology Career Development AwardLeonard M. Miller School of Medicine Dean's Research Excellence Award in Medicine from the University of Miami Miller School of MedicineNIH Clinical Center Cancer Center Support Grant (5P30 240139-02)NIH Clinical Center NIH K12 Paul Calabresi Award (K12CA226330)NIH Clinical Center T32 Research GrantV Foundation for Cancer Research V Foundation Award
6 · The paper itself

Abstract

purposeDisparities in breast cancer survival remain a challenge. We aimed to analyze the effect of structural racism, as measured by the Index of Concentration at the Extremes (ICE), on receipt of National Cancer Center Network (NCCN) guideline-concordant breast cancer treatment.

methodsWe identified patients treated at two institutions from 2005 to 2017 with stage I-IV breast cancer. Census tracts served as neighborhood proxies. Using 5-year estimates from the American Community Survey, 5 ICE variables were computed to create 5 models, controlling for economic segregation, non-Hispanic Black (NHB) segregation, NHB/economic segregation, Hispanic segregation, and Hispanic/economic segregation. Multi-level logistic regression models were used to determine the association between individual and neighborhood-level characteristics on receipt of NCCN guideline-concordant breast cancer treatment.

results5173 patients were included: 55.2% were Hispanic, 27.5% were NHW, and 17.3% were NHB. Regardless of economic or residential segregation, a NHB patient was less likely to receive appropriate treatment [(OR)

conclusionTo our knowledge, this is the first analysis assessing receipt of NCCN guideline-concordant treatment by ICE, a validated measure for structural racism. While much literature emphasizes neighborhood-level barriers to treatment, our results demonstrate that compared to NHW patients, NHB patients are less likely to receive NCCN guideline-concordant breast cancer treatment, independent of economic or residential segregation. Our study suggests that there are potential unaccounted individual or neighborhood barriers to receipt of appropriate care that go beyond economic or residential segregation.

Indexed as

Breast NeoplasmsGuideline AdherenceHealthcare DisparitiesSystemic RacismAdultAgedBlack or African AmericanFemaleHispanic or LatinoHumansMiddle AgedPractice Guidelines as TopicRacismResidence CharacteristicsSocioeconomic FactorsUnited StatesBreast cancerBreast cancer treatmentIndex of concentration at the extremesSegregationStructural racism

Identifiers

PMID38809304

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.