title: Use and timeliness of radiation therapy after breast-conserving surgery in low-income women with early-stage breast cancer.
abstract: OBJECTIVE
  To characterize overall receipt and timeliness of radiation therapy (RT) following breast-conserving surgery among Medicaid-insured patients.
  
  
  METHODS
  State cancer registry data linked with Medicaid claims from 2003 to 2009 were analyzed. Multivariate logistic and Cox proportional hazards regressions were employed.
  
  
  RESULTS
  Overall, 81% of patients received guideline-recommended RT. Significant variation in timing of RT initiation was documented. Having fewer comorbitidies and receiving chemotherapy were correlated with higher odds of RT initiation within 1 year.
  
  
  CONCLUSIONS
  Although RT use in Medicaid-insured women appears to have improved since earlier studies, documented delays in RT are troublesome and warrant further investigation.
authors.affiliation: Department of Health Policy and Management, Gillings School of Global Public Health. Stephanie wheeler@unc.edu
authors.forename: Stephanie B
authors.initials: SB
authors.lastname: Wheeler
authors.forename: Yang
authors.initials: Y
authors.lastname: Wu
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Meyer
authors.forename: William R
authors.initials: WR
authors.lastname: Carpenter
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Richardson
authors.forename: Judith Lee
authors.initials: JL
authors.lastname: Smith
authors.forename: Megan A
authors.initials: MA
authors.lastname: Lewis
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Weiner
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D015412:Mastectomy, Segmental; D008484:Medicaid; D008875:Middle Aged; D009367:Neoplasm Staging; D009657:North Carolina; D011203:Poverty / Q000706:statistics & numerical data*; D018714:Radiotherapy, Adjuvant / Q000379:methods* / Q000706:statistics & numerical data*; D012923:Social Class; D014481:United States; D055815:Young Adult