title: Survival Benefits of Treatment Access Among Underserved Breast Cancer Patients Diagnosed Through the Texas Breast and Cervical Cancer Services Program.
abstract: OBJECTIVE
  The Texas Breast and Cervical Cancer Services (BCCS) program was established to address socioeconomic disparities in breast and cervical cancer screening and survival. This study examined the impact of the program on treatment and survival of breast cancer patients.
  
  
  METHODS
  A retrospective analysis was performed using the Texas Cancer Registry data linked to the BCCS program data. The sample consisted of 40- to 64-year-old women screened and diagnosed with breast cancer through the BCCS program (participants) and similar women living in low socioeconomic status census tracts and diagnosed outside the program (comparison group) during 1995-2008. Regular screeners among the participants were also compared with the comparison group.
  
  
  RESULTS
  Participants had lower rates of breast surgery and higher rates of chemotherapy as compared with the comparison group. Participants undergoing surgery had higher rates of mastectomy (as compared with breast-conserving surgery) and lower rates of adjuvant radiation therapy. Unadjusted survival rates were similar between the participants and the comparison group, and higher among regular screeners, which was primarily driven by stage at diagnosis. Adjusted survival rates were similar between the 3 groups.
  
  
  CONCLUSIONS
  Although there are differences in the types of treatment provided to the participants and the comparison group, there is no evidence of guideline noncompliance or stage-inappropriate treatment provision in either of the groups. Despite being diagnosed with a more advanced stage, the participants had similar unadjusted and adjusted survival rates as the comparison group. Access to timely treatment improved survival and brought the underserved participants on par with the comparison group.
authors: Department of Management, Policy and Community Health (Drs Rajan, Begley, and Highfield and Mr Kim) and Center for Health Services Research (Drs Rajan and Begley), School of Public Health, The University of Texas Health Science Center at Houston.
authors: Suja S
authors: SS
authors: Rajan
authors: Charles E
authors: CE
authors: Begley
authors: Linda D
authors: LD
authors: Highfield
authors: Bumyang
authors: B
authors: Kim
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D055088:Early Detection of Cancer; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D012042:Registries; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D015996:Survival Rate; D013781:Texas / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology