Older adults with stage I to III breast cancer who identified as non-Hispanic Black face racial disparities in breast cancer care. have increased odds of not receiving guideline-concordant care or timely treatment compared with patients who are non-Hispanic White, according to a study published in JAMA Network Open.

Since 1989, breast cancer occurrence and trends have decreased by 44%, according to the American Cancer Society. This decline, according to the authors, “is partly attributable to improved systemic treatment for early-stage breast cancer.” However, there continue to be disparities in breast cancer care and survival among different demographic groups following a diagnosis, especially individuals who identify as non-Hispanic and Black.

Between 2015 and 2019, non-Hispanic Black women were just as likely to receive a breast cancer diagnosis but had a 40% higher chance of mortality compared with non-Hispanic White women, demonstrating the continuing disparities in breast cancer care. Differences in survival rates among various groups may be linked to disparities in the receipt of guideline-concordant cancer care and timely initiation of therapy.

Patients with breast cancer were enrolled in a retrospective cohort analysis from the National Cancer Database (NCDB) from July 2022 to June 2023. Data included a nationwide oncology outcomes database that captured about 70% of all newly diagnosed cancers within the US.

There were 258,531 eligible patients (9.7%, non-Hispanic Black; 90.3% non-Hispanic White) with an average age of 72.5 years, 15.4% of whom did not receive guideline-concordant multimodality therapy. Overall, 18.1% of non-Hispanic Black patients did not receive guideline-concordant care compared with 15.2% of non-Hispanic White individuals, indicating ongoing disparities in breast cancer care.

Non-Hispanic Black patients were associated with greater odds of nonreceipt of guideline-concordant care after clinical and demographic variables were adjusted for the model (adjusted OR, 1.13; 95% CI, 1.08-1.17; P < .001). Individuals of non-Hispanic Black race were associated with a 26.1% increased risk of all-cause mortality in the univariate analysis. After adjusting for guideline-concordant care and clinical/sociodemographic factors, overall mortality risk decreased to 4.7% (adjusted HR, 1.05; 95% CI, 1.01-1.08; P = .006).

Patients 75 years or older with stage III disease, who had a higher Charlson-Deyo comorbidity index score, were associated with the largest magnitude for all-cause mortality not mediated by guideline-concordant care, demonstrating the disparities in breast cancer care present.

Read the full article about racial disparities in breast cancer care by Cameron Santoro at AJMC.