Abstract A107: Income disparities in the receipt and adherence to adjuvant hormonal therapy in a cohort of young estrogen receptor-positive breast cancer cases

Abstract

Abstract This study aimed to investigate the relationship between income and the receipt and adherence to adjuvant hormonal therapy (AHT) in a cohort of estrogen receptor (ER)-positive, invasive breast cancer cases. Women age 20 to 45 with a first primary diagnosis of invasive breast cancer between 2004 and 2010 were identified from the Cancer Surveillance System of Western Washington and given a telephone interview to ascertain data on breast cancer risk factors, demographic characteristics, and treatment history. A total of 602 invasive ER-positive cases were available for this analysis which uses logistic regression to compare the odds of starting and discontinuing AHT, such as Tamoxifen, Letrozole, Anastrozole, or Leuprolide, by categories of annual household income adjusting for household size and age. 72% of women received any AHT and 14% of women had discontinued AHT by the time of the interview. Of those who discontinued AHT, 53% had discontinued after less than one year of starting. There were no differences in the likelihood of starting AHT by income. However, women with an income of less than $50,000 were 2.4 times more likely to report discontinuing use than women with an income of $50,000 or more (Odds ratio(OR)=2.42; 95% Confidence interval(CI)=1.32-4.41). The income disparity in the likelihood of discontinuing AHT is particularly stark when comparing women with an income of ≥$90,000 to those with an income of <$25,000 (OR=4.66; 95% CI = 1.91–11.36). The financial burden of breast cancer treatment may cause women with limited resources to discontinue AHT, putting them at greater risk of poor disease outcomes. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A107.