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Gaps in Breast Cancer Receptor Testing Among Specific Groups


Core Concepts
Breast cancer receptor testing disparities exist among specific populations.
Abstract

The study analyzed over 300,000 patients with invasive breast cancer to identify gaps in receptor testing among certain groups.

TOPLINE:

  • Testing lags in older women, Black women, rural area residents, and those with distant or unstaged cancers.

METHODOLOGY:

  • Guidelines recommend estrogen, progesterone, and HER2 receptor status testing.
  • Data from 2012-2016 on 321,913 women with invasive breast cancer were reviewed.

TAKEAWAY:

  • 4.7% of women had missing components of receptor status.
  • Odds of missing components were higher in older women, Black women, and those with distant or unstaged cancers.

IN PRACTICE:

  • Missing components persist, especially in certain socioeconomic populations.
  • Study results can aid in targeting affected populations to reduce health disparities.

SOURCE:

  • Led by Julie Stephens, MS, of Ohio State University, the study was published in JAMA Network Open.

LIMITATIONS:

  • Data do not include severe comorbidities or recent trends post-2016.

DISCLOSURES:

  • Funded by the Ohio Department of Health, with senior investigator Electra Paskett, PhD, having industry ties.
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Stats
Overall, 4.7% of women had missing components of receptor status. Odds of missing components were higher in certain groups: older women, Black women, women with distant or unstaged cancers. Cases reported by different facilities were more likely to have missing components of receptor status. Missing components were more likely for women in rural areas and those with unknown insurance status.
Quotes
"The results of this study may help clinicians, public health practitioners, and policymakers target affected populations to minimize or eliminate this critical health disparity and help save more lives." - Authors

Deeper Inquiries

How can healthcare systems address the disparities in breast cancer receptor testing among different demographic groups?

Healthcare systems can address the disparities in breast cancer receptor testing among different demographic groups by implementing targeted interventions. This can include increasing awareness and education about the importance of receptor testing in all populations, especially among older women, Black women, and those from rural areas. Healthcare providers should be trained to recognize the factors that contribute to missing components of receptor status and work towards ensuring that all patients receive appropriate testing. Additionally, improving access to healthcare facilities, particularly in underserved areas, can help bridge the gap in testing disparities. Collaborations between healthcare providers, public health practitioners, and policymakers are essential to develop strategies that target affected populations and minimize health disparities in breast cancer receptor testing.

What potential criticisms could arise regarding the methodology or findings of this study?

Potential criticisms regarding the methodology or findings of this study could include concerns about the generalizability of the results. The study focused on data from the Surveillance, Epidemiology, and End Results (SEER) database from 2012-2016, which may not reflect more recent trends in breast cancer receptor testing. Critics may also question the accuracy of the data, as the study did not capture severe comorbidities or other factors that could influence the need for receptor testing. Additionally, there may be concerns about the study's reliance on retrospective data and the potential for bias in the analysis. Critics could also argue that the study did not delve deeply enough into the reasons behind the disparities in receptor testing among different demographic groups.

How can advancements in technology impact the accuracy and accessibility of breast cancer receptor testing in the future?

Advancements in technology can significantly impact the accuracy and accessibility of breast cancer receptor testing in the future. For instance, the development of more sensitive and specific testing methods can improve the accuracy of receptor status determination, leading to better treatment decisions for patients. Additionally, technological advancements can enhance the accessibility of testing by making it more cost-effective and less invasive. For example, the use of liquid biopsy tests and digital pathology can streamline the testing process and reduce the need for invasive procedures. Telemedicine and remote monitoring technologies can also improve access to testing for patients in rural or underserved areas. Overall, advancements in technology have the potential to revolutionize breast cancer receptor testing, making it more accurate, efficient, and accessible for all patients.
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