Racial Differences in Adjuvant Endocrine Therapy Use and Discontinuation in Association with Mortality among Medicare Breast Cancer Patients by Receptor Status

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology
Albert J Farias, Xianglin L Du

Abstract

Background: There are racial disparities in breast cancer mortality. Our purpose was to determine whether racial/ethnic differences in use and discontinuation of adjuvant endocrine therapy (AET) differed by hormone receptor status and whether discontinuation was associated with mortality.Methods: We conducted a retrospective cohort study with SEER/Medicare dataset of women age ≥65 years diagnosed with stage I-III breast cancer in Medicare Part-D from 2007 to 2009, stratified by hormone receptor status. We performed multivariable logistic regressions to assess racial differences for the odds of AET initiation and Cox proportional hazards models to determine the risk of discontinuation and mortality.Results: Of 14,902 women, 64.5% initiated AET <12 months of diagnosis. Among those with hormone receptor-positive cancer, 74.8% initiated AET compared with 5.6% of women with negative and 54.0% with unknown-receptor status. Blacks were less likely to initiate [OR, 0.76; 95% confidence interval (CI), 0.66-0.88] compared with whites. However, those with hormone receptor-positive disease were less likely to discontinue (HR, 0.89; 95% CI, 0.80-0.98). Women who initiated with aromatase inhibitors had increased risk of discontinuation compa...Continue Reading

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Citations

May 1, 2019·Journal of Managed Care & Specialty Pharmacy·Vanessa B SheppardMahlet G Tadesse
Oct 10, 2020·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Gabriela ToledoAlbert J Farias
Jan 31, 2021·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Vanessa B SheppardMahlet G Tadesse
May 12, 2021·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Ambarina S FaizClaire S Philipp
Nov 2, 2021·Breast Care·Christian Felix ReiboldEva Johanna Kantelhardt

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