National Healthcare Disparities Report - LDI Health Economist

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Effectiveness of Care Chapter 2 Cancer NEW n From 2000 to 2008, the percentage of non-Hispanic White women ages 50-74 who reported they had a mammogram in the past 2 years fell from 79% to 74%. There were no statistically significant changes in rates among other racial and ethnic groups (Figure 2.1). n Asian women were less likely to have a mammogram than White women and Hispanic women were less likely to have a mammogram than non-Hispanic White women in all years except 2008. n The 2008 top 5 State achievable benchmark was 88%. iv There is no evidence of progress toward the benchmark by any racial or ethnic group. Also, in the NHQR: n In all years, among women ages 50-64, uninsured women were less likely to have a mammogram than those with private insurance. Among women ages 65-74, those with Medicare only were less likely to have a mammogram than those with Medicare and any private supplemental insurance. Medicare does not cover all health care costs. Medicare beneficiaries can purchase private supplemental insurance from insurance companies to help pay for coinsurance, copayments, and deductibles. Beneficiaries with Medicare only typically must pay out of pocket for costs not covered by Medicare. Outcome: Breast Cancer First Diagnosed at Advanced Stage Cancers can be diagnosed at different stages of development. Cancers diagnosed early before spread has occurred are generally more amenable to treatment and cure; cancers diagnosed late with extensive spread often have poor prognoses. The rate of cancer cases diagnosed at advanced stages is a measure of the effectiveness of cancer screening efforts and of adherence to followup care after a positive screening test. Because many cancers often take years to develop, changes in rates of late-stage cancer may lag behind changes in screening rates. In past reports, rates of advanced stage cancer from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program were reported. Estimates for the Nation were based on 13 SEER areas encompassing about 26% of the U.S. population. Beginning in the 2011 NHQR and NHDR, data from the SEER program and the National Program on Cancer Registries were combined to calculate national statistics on rates of advanced stage cancer. Together, the SEER program and the National Program on Cancer Registries collect cancer data for the entire U.S. population. iv The top 5 States contributing to the achievable benchmark are Connecticut, Delaware, Massachusetts, New Hampshire, and Rhode Island. 52 National Healthcare Disparities Report, 2011
Effectiveness of Care Figure 2.2. Age-adjusted rate of advanced stage breast cancer per 100,000 women age 40 and over, by race and ethnicity, 2000-2007 125 White Black AI/AN API 125 Non-Hispanic White Hispanic 100 100 Rate per 100,000 Population 75 50 25 2007 Achievable Benchmark: 79 Rate per 100,000 Population 75 50 25 2007 Achievable Benchmark: 79 Chapter 2 Cancer 0 2000 2001 2002 2003 2004 2005 2006 2007 0 2000 2001 2002 2003 2004 2005 2006 2007 Key: AI/AN = American Indian or Alaska Native; API = Asian or Pacific Islander. Source: Centers for Disease Control and Prevention, National Program of Cancer Registries and National Cancer Institute, Surveillance, Epidemiology, and End Results (SEER) Program, 2000-2007. Registries meeting United States Cancer Statistics publication criteria for every year, 2000-2007, are included and cover 89.3% of the total U.S. population. States excluded are DC, Mississippi, Nevada, North Carolina, South Dakota, Tennessee, and Virginia. Denominator: Women age 40 and over. Note: For this measure, lower rates are better. Age adjusted to the 2000 U.S. standard population. Advanced stage breast cancer is defined as local stage with tumor size greater than 2 cm diameter, regional stage or distant stage. n From 2000 to 2007, the rate of advanced stage breast cancer in Black women increased from 99 to 108 per 100,000 women. There were no statistically significant changes in rates among other racial and ethnic groups (Figure 2.2). n In all years, rates were lower among Asian or Pacific Islander (API) and American Indian or Alaska Native (AI/AN) women compared with White women and among Hispanic women compared with non-Hispanic White women. Since 2003, rates have been higher among Black women compared with White women. n The 2007 top 5 State achievable benchmark was 79 per 100,000 women. v AI/AN, API, and Hispanic women have achieved the benchmark while Black women are moving away from it. Also, in the NHQR: n In all years, women ages 50-64 and 65 and over had higher rates than women ages 40-49. v The top 5 States contributing to the achievable benchmark are Arizona, Florida, New Hampshire, West Virginia, and Wyoming. National Healthcare Disparities Report, 2011 53
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NATIONAL HEALTHCARE DISPARITIES REP
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National Healthcare Disparities Rep
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U.S. Department of Health and Human
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