Early stage breast cancer treatments for younger Medicare beneficiaries with different disabilities.
OBJECTIVE
To explore how underlying disability affects treatments and outcomes of disabled women with breast cancer.


METHODS
Surveillance, Epidemiology, and End Results program data, linked with Medicare files and Social Security Administration disability group.


METHODS
Ninety thousand two hundred and forty-three incident cases of early-stage breast cancer under age 65; adjusted relative risks and hazards ratios examined treatments and survival, respectively, for women in four disability groups compared with nondisabled women.


RESULTS
Demographic characteristics, treatments, and survival varied among four disability groups. Compared with nondisabled women, those with mental disorders and neurological conditions had significantly lower adjusted rates of breast conserving surgery and radiation therapy. Survival outcomes also varied by disability type.


CONCLUSIONS
Compared with nondisabled women, certain subgroups of women with disabilities are especially likely to experience disparities in care for breast cancer.
Iezzoni
Lisa I
LI
Institute for Health Policy, Division of Medicine, Massachusetts General Hospital and Harvard Medical School, 50 Staniford St., Rm 901C, Boston, MA 02114, USA.
Ngo
Long H
LH
Li
Donglin
D
Roetzheim
Richard G
RG
Drews
Reed E
RE
McCarthy
Ellen P
EP
D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015897:Comorbidity; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000145:classification*; D006278:Medicare / Q000706:statistics & numerical data*; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018426:SEER Program; D012959:Socioeconomic Factors; D014481:United States