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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 1/2018

01-02-2018 | Epidemiology

Racial disparities in omission of oncotype DX but no racial disparities in chemotherapy receipt following completed oncotype DX test results

Authors: David J. Press, Abiola Ibraheem, M. Eileen Dolan, Kathleen H. Goss, Suzanne Conzen, Dezheng Huo

Published in: Breast Cancer Research and Treatment | Issue 1/2018

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Abstract

Purpose

To examine racial/ethnic disparities in Oncotype DX (ODX) testing among patients with node-negative, estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancers and possible racial/ethnic disparities in chemotherapy receipt following ODX testing within Recurrence Score (RS) category (Not Done, Low, Intermediate, High), as well as chemotherapy receipt time trends within RS categories.

Methods

A retrospective cohort list of 125,288 women who were potentially indicated for ODX testing from 2010 to 2014 was obtained using the National Cancer Database. We fit multivariate logistic regression predicting chemotherapy receipt, adjusting for clinical factors, patient demographic factors, and hospital-level factors, separately by RS category, and calculated odds ratios (OR) and 95% confidence intervals (CI), as well as time trends.

Results

Overall, ODX testing was completed for 46.1% of Non-Hispanic (NH) Whites, 43.9% of NH Blacks, and 41.7% of Hispanics. Among patients who did not receive ODX testing, NH Black and Hispanic women both experienced statistically significant increases in chemotherapy receipt relative to NH White women (NH Black OR 1.23; 95% CI 1.11–1.37; Hispanic OR 1.23; 95% CI 1.07–1.42). However, among patients with ODX results, no statistically significant racial/ethnic differences in chemotherapy receipt were observed within strata of RS category. Trend analyses demonstrated increasing adherence to national guidelines for ODX testing.

Conclusions

We identified racial disparities in omission of ODX testing but no differences in chemotherapy receipt if ODX test results were obtained, suggesting increasing access to ODX testing may improve racial equality in efficacious use of adjuvant chemotherapy for ER-positive HER2-negative breast cancer.
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Metadata
Title
Racial disparities in omission of oncotype DX but no racial disparities in chemotherapy receipt following completed oncotype DX test results
Authors
David J. Press
Abiola Ibraheem
M. Eileen Dolan
Kathleen H. Goss
Suzanne Conzen
Dezheng Huo
Publication date
01-02-2018
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2018
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-017-4587-8

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