Cancer publishes study confirming disparity in breast cancer treatment

WILMINGTON, Del.—Feb. 16, 2010—Cancer, the peer-reviewed international journal of the American Cancer Society, has published a study conducted by HealthCore, Inc. in its Jan. 1 edition, demonstrating disparities in breast cancer treatment between commercially insured African-American and white women.

The HealthCore study reiterates the findings of previous studies — conducted in populations using government health programs — that African-American women are diagnosed in later stages of the disease.

Breast cancer is the second most common cause of cancer death in white and African-American women in the United States.

"This study demonstrates that disparities in breast cancer care exist even when patients have access to employer-provided healthcare," said Dr. Joe Singer, HealthCore vice president for clinical affairs. "A key takeaway from our study is that African-American women were diagnosed with breast cancer at younger ages, but in later stages of breast cancer, when chances of survival diminish greatly."

The study, funded by Amgen, was conducted in collaboration with Blue Cross and Blue Shield of Georgia and the American Cancer Society. HealthCore is working with Blue Cross and Blue Shield of Georgia and the American Cancer Society to further evaluate the study to understand more about the women who are newly diagnosed with breast cancer so the health plan can determine better ways to communicate with them and their physicians in an attempt to diminish the disparities.

The HealthCore study also found that not all women who tested positive for hormone receptor cancer received anti-estrogen therapy, which is a standard of care set by guidelines established by the National Comprehensive Cancer Network and the American Cancer Society. Of those women who did test positive, white women were more likely than African-American women to receive anti-estrogen therapy.

Specifically, the study found:

• White women (55.2 percent) were more likely than African- American women (38.4 percent) to be diagnosed with stage 0 or stage I disease.
• Twice as many African-American women (6.1 percent) compared with white women (3.6 percent) were diagnosed with stage IV disease.
• Among women who tested positive for hormone receptor cancer, African-American women were less likely to receive treatment, such as aromatase inhibitors or tamoxifen.
• White women were twice as likely to receive anti-estrogen therapy compared with African-American women, after adjusting for age, cancer stage, and social economic status.

"While treatment for depression and anxiety occurred in both groups, less than half of those women had notes in their medical charts to follow-up with their primary care physician and only one women was referred to a mental health professional," said Dr. Otis Brawley, chief medical officer for the American Cancer Society and study co-author. "Clearly, this is a health intervention needed for both African-American and white women."

The study pool of 3,017 women was identified from a medical claims database with information extracted from medical chart data on 766 women. Of those patients who had race data, 79.8 percent were white and 16.6 percent were African-American.

Health plan claims data were then linked to information abstracted from medical charts to measure age, use of medications and to obtain detailed clinical information regarding their breast cancer and co-morbid medical conditions present at the time of the breast cancer diagnosis. HealthCore also collected data on the cancer-specific treatment received, adverse events, supportive care and oncologist follow-up communication with primary care physicians.

HealthCore, based in Wilmington, Del., is the clinical outcomes research subsidiary of WellPoint. HealthCore has a team of highly experienced researchers including physicians, biostatisticians, pharmacists, epidemiologists, health economists and other scientists who study the "real world" safety and effectiveness of drugs, medical devices and care management interventions. HealthCore offers insight on how to best use this data and communicates these findings to health care decision-makers to support evidence-based medicine, product development decisions, safety monitoring, coverage decisions, process improvement and overall cost-effective health care. For more information, go to www.healthcore.com.

Media contact:
Lori McLaughlin, 317.488.6898/317.407.7403
lori.mclaughlin2@wellpoint.com