부산대학교 도서관

Simple Summary: Breast cancer is the most diagnosed cancer in women. Women who are diagnosed early and who receive evidence-based guideline-adherent care have better outcomes. Previous studies have shown disparities in the receipt of appropriate care based on race and socioeconomic status. This study was designed to explore these disparities in women diagnosed with triple-negative breast cancer in the context of the receipt of National Comprehensive Cancer Network guideline-adherent care and its effects on outcomes using the California Cancer Registry. Our results show that racial minorities and members of lower socioeconomic groups are less likely to receive guideline-adherent care, and that this is associated with an increased risk of dying from breast cancer. Our study adds to the growing evidence of persistent healthcare disparities, suggesting that more work is needed to bridge the gaps in healthcare provision for racial minorities and members of lower socioeconomic groups. Background: The National Comprehensive Cancer Network guidelines were designed to improve patient outcomes. Here, we examine factors that may contribute to outcomes and guideline adherence in patients with triple-negative breast cancer. Methods: This was a retrospective cohort study of women with triple-negative breast cancer using the California Cancer Registry. Adherent treatment was defined as the receipt of a combination of surgery, lymph node assessment, adjuvant radiation, and/or chemotherapy. A multivariable logistic regression was used to determine the effects of independent variables on adherence to the NCCN guidelines. Disease-specific survival was calculated using Cox regression analysis. Results: A total of 16,858 women were analyzed. Black and Hispanic patients were less likely to receive guideline-adherent care (OR 0.82, 95%CI 0.73–0.92 and OR 0.87, 95%CI 0.79–0.95, respectively) compared to White patients. Hazard ratios adjusted for adherent care showed that Black patients had increased disease-specific mortality (HR 1.28, 95%CI 1.16–1.42, p < 0.0001) compared to White patients. Conclusions: A significant majority of breast cancer patients in California continue to receive non-guideline-adherent care. Non-Hispanic Black patients and patients from lower SES quintile groups were less likely to receive guideline-adherent care. Patients with non-adherent care had worse disease-specific survival compared to recipients of NCCN guideline-adherent care. [ABSTRACT FROM AUTHOR]