Abstract B19: Improving initiation of adjuvant hormonal therapy in black women under 50 may contribute towards narrowing racial gaps in breast cancer

Abstract

Abstract Background: The advent of adjuvant hormonal therapy has greatly improved breast cancer survival in women with hormonal receptor (HR) positive breast cancer. Unfortunately, racial disparities have been noted in both the uptake of adjuvant hormonal therapy and in women with HR positive breast cancer. Purpose: In a prospective study, we examined the influence of race, socio-cultural factors, and process of care factors on initiation of adjuvant hormonal therapy. Methods: Eligible women were newly diagnosed with invasive, non-metastatic hormonal receptor positive (HR) breast cancer. Socio-cultural and healthcare factors were collected via telephone surveys; clinical data were abstracted from charts. Stepwise logistic regression models examined associations between hormonal initiation and study factors. Results: The sample was 56% Black (n=150) and 44% White (n=120). Overall 70% initiated therapy with Black women <50 having the lowest rate of initiation (51%) among all Black and White age groups. A significant interaction (p= .002) was found between race and age so a stratified race – age composite variable was created. In multivariate models, Black women < 50 years were less likely to initiate therapy compared to Whites ≥50 (OR: .28; 95% CI: .10 to .82), whites <50 (OR: 0.19; 95% CI: 0.05 to 0.68), or compared to blacks ≥50 (OR: .34; 95% CI: 0.12 to 0.96). Women reporting having higher ratings of financial access were more likely to initiate therapy as were those with higher ratings of communication with their providers. Conclusion: Attention to financial aspects of cancer care and patient-provider communication may be useful points of intervention to improve initiation in patients, particularly Black patients <50 years of age. Citation Format: Vanessa B. Sheppard, Claudine Isaacs, Mahlet G. Tadesse, Melissa Butler, Felicity Harper, Fikru Hirpa. Improving initiation of adjuvant hormonal therapy in black women under 50 may contribute towards narrowing racial gaps in breast cancer. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr B19.