Racial and ethnic differences in adjuvant hormonal therapy use.
BACKGROUND
In the United States, 5-year breast cancer survival is highest among Asian American women, followed by non-Hispanic white, Hispanic, and African American women. Breast cancer treatment disparities may play a role. We examined racial/ethnic differences in adjuvant hormonal therapy use among women aged 18-64 years, diagnosed with hormone receptor-positive breast cancer, using data collected by the Northern California Breast Cancer Family Registry (NC-BCFR), and explored changes in use over time.


METHODS
Odds ratios (OR) comparing self-reported ever-use by race/ethnicity (African American, Hispanic, non-Hispanic white vs. Asian American) were estimated using multivariable adjusted logistic regression. Analyses were stratified by recruitment phase (phase I, diagnosed January 1995-September 1998, phase II, diagnosed October 1998-April 2003) and genetic susceptibility, as cases with increased genetic susceptibility were oversampled.


RESULTS
Among 1385 women (731 phase I, 654 phase II), no significant racial/ethnic differences in use were observed among phase I or phase II cases. However, among phase I cases with no susceptibility indicators, African American and non-Hispanic white women were less likely than Asian American women to use hormonal therapy (OR 0.20, 95% confidence interval [CI]0.06-0.60; OR 0.40, CI 0.17-0.94, respectively). No racial/ethnic differences in use were observed among women with 1+ susceptibility indicators from either recruitment phase.


CONCLUSIONS
Racial/ethnic differences in adjuvant hormonal therapy use were limited to earlier diagnosis years (phase I) and were attenuated over time. Findings should be confirmed in other populations but indicate that in this population, treatment disparities between African American and Asian American women narrowed over time as adjuvant hormonal treatments became more commonly prescribed.
Department of Health Evidence and Policy, Mount Sinai School of Medicine, 1425 Madison Avenue, New York, NY 10029, USA. jclivaudais@gmail.com
Jennifer C
JC
Livaudais
Christopher
C
Li
Esther M
EM
John
Mary Beth
MB
Terry
Mary
M
Daly
Saundra S
SS
Buys
Laurel
L
Habel
Beti
B
Thompson
N David
ND
Yanez
Gloria D
GD
Coronado
D000293:Adolescent; D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000208:ethnology*; D002140:California / Q000453:epidemiology; D017024:Chemotherapy, Adjuvant; D004363:Drug Utilization; D005260:Female; D020022:Genetic Predisposition to Disease; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D012042:Registries; D057566:Self Report; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D018931:Antineoplastic Agents, Hormonal