Evidence map›Paper›PMID 41563590›Full record

ArticleCancer causes & control : CCC2026

Guideline-concordance along the cancer care continuum and breast cancer mortality by race and ethnicity: a SEER-Medicare study.

Emma L Herbach, Ryan M Carnahan, Lauren E McCullough, Bradley D McDowell, Michaela Curran, Kai Wang, Ingrid M Lizarraga, Mary E Charlton, Sarah H Nash

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer causes & control : CCC, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
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

9 authors.

Emma L HerbachDepartment of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA. eherbach@miami.edu.ORCID http://orcid.org/0000-0003-4090-9174
Ryan M CarnahanDepartment of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA.
Lauren E McCulloughDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Bradley D McDowellUniversity of Iowa Holden Comprehensive Cancer Center, Iowa City, IA, USA.
Michaela CurranDepartment of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA, USA.
Kai WangDepartment of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA.
Ingrid M LizarragaDepartment of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Mary E CharltonDepartment of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA.
Sarah H NashNew Mexico Tumor Registry, Albuquerque, NM, USA.

Funding

Viral VectorP30CA086862 · NCI · UNIVERSITY OF IOWA · PI Jon C.D. Houtman · 2000 to 2026
$70.0M
PROSPR METRICS CISNET Collaboration Investigating Impact of Structural Racism/Discrimination on Cervical Screening Moonshot SupplementUM1CA221940 · NCI · UT SOUTHWESTERN MEDICAL CENTER · PI CHUBAK, JESSICA, HAAS, JENNIFER S · 2018 to 2023
$15.9M
Optimizing Colorectal Cancer Screening PREcision and Outcomes in CommunIty-baSEd Populations (PRECISE)UM1CA222035 · NCI · KAISER FOUNDATION RESEARCH INSTITUTE · PI CHUBAK, JESSICA, CORLEY, DOUGLAS ALLEN · 2018 to 2023
$15.6M
Center for Research to Optimize Precision Lung Cancer Screening in Diverse PopulationsUM1CA221939 · NCI · KAISER FOUNDATION RESEARCH INSTITUTE · PI RITZWOLLER, DEBRA P, VACHANI, ANIL · 2018 to 2023
$15.3M
Project 3: GLP1R and GIPR Agonists in GEP NETs ProjectP50CA302572 · NCI · UNIVERSITY OF IOWA · PI JAMES R HOWE, Yusuf Menda · 2025 to 2026
$6.5M
Coordinating Center for Population-based Research to Optimize Cancer Screening (PROSPR) (U24)U24CA221936 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI LI, CHRISTOPHER I, ZHENG, YINGYE · 2018 to 2023
$5.7M
NCCDPHP CDC HHS U58 DP003862NCI NIH HHS HHSN261201000034CNCI NIH HHS HHSN261201000035CNCI NIH HHS HHSN261201000035INCI NIH HHS HHSN261201000140CNCI NIH HHS HHSN261201800012INCI NIH HHS P30 CA086862NCI NIH HHS P50 CA302572NCI NIH HHS U24 CA221936NCI NIH HHS UM1 CA221939NCI NIH HHS UM1 CA221940NCI NIH HHS UM1 CA222035
6 · The paper itself

Abstract

purposeTo examine the relationship between guideline-concordant breast cancer care and hazard of cancer death by patient race and ethnicity.

methodsWe used SEER-Medicare data to identify 212,555 older women diagnosed with invasive breast cancer between 2000 and 2017. Guideline-concordant diagnostic workup, locoregional treatment, and initiation of systemic therapy were defined using NCCN guidelines. Hazards of breast cancer death 2 and 5 years from diagnosis by each guideline-concordance outcome overall and stratified by race and ethnicity were estimated using Cox proportional hazards models.

resultsNon-concordant diagnostic workup, locoregional treatment, and systemic therapy initiation were each associated with increased hazards of 2- and 5-year breast cancer mortality (diagnostics HR

conclusionEquitable delivery of guideline-recommended breast cancer care from diagnosis through treatment across racial and ethnic groups may mitigate survival disparities. Efforts to improve access to high-quality care must be informed by and responsive to the social and structural root causes of health inequities.

Indexed as

Breast NeoplasmsContinuity of Patient CareEthnicityGuideline AdherenceAgedAged, 80 and overFemaleHealthcare DisparitiesHumansMedicarePractice Guidelines as TopicRacial GroupsSEER ProgramUnited StatesBreast cancerGuideline-concordant careRacial disparitiesSurvival

Identifiers

PMID41563590
PMCPMC12823728

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.