National Healthcare Disparities Report - LDI Health Economist

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Effectiveness of Care Treatment: Recommended Care for Breast Cancer Different diagnostic and treatment options exist for various types of cancer. Some aspects of cancer care are well established as beneficial and are commonly recommended. The appropriateness of recommended care depends on different factors, such as the stage or extent of the cancer within the body (especially whether the disease has spread from the original site to other parts of the body). Other types of care are important for accurate diagnosis, such as ensuring adequate examination of lymph nodes when surgery is performed. Figure 2.3. Women with clinical Stage I-IIb breast cancer who received axillary node dissection or sentinel lymph node biopsy at the time of lumpectomy or mastectomy, by race and ethnicity, 2004-2008 Chapter 2 Cancer 100 White Black 95 90 NHOPI 2008 Achievable Benchmark: 97% AI/AN Asian 100 95 90 Total Non-Hispanic White Hispanic 2008 Achievable Benchmark: 97% Percent 85 Percent 85 80 80 75 Z 0 2004 2005 2006 2007 2008 75 Z 0 2004 2005 2006 2007 2008 Key: NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native. Source: Commission on Cancer, American College of Surgeons and American Cancer Society, National Cancer Data Base, 2004-2008. Denominator: Women with Stage I-IIb breast cancer undergoing lumpectomy or mastectomy. n The percentage of women with clinical Stage I-IIb breast cancer who received axillary node dissection or sentinel lymph node biopsy at the time of lumpectomy or mastectomy increased from 85% in 2004 to 94% in 2008 (Figure 2.3). Significant improvement was observed among all racial and ethnic groups except AI/ANs. n In all years, Asian women were more likely than White women to receive axillary node dissection or sentinel lymph node biopsy. n The 2008 top 5 State achievable benchmark was 97%. vi At the current rate of increase, most women could achieve the benchmark in 1 year. vi The top 5 States contributing to the achievable benchmark are Minnesota, Mississippi, Nevada, Oklahoma, and South Dakota. 54 National Healthcare Disparities Report, 2011
Effectiveness of Care Also, in the NHQR: n In all years, women ages 70-79 and 80 and over were less likely than women under age 40 to receive axillary node dissection or sentinel lymph node biopsy. Women under age 65 with public health insurance only were less likely than those with private insurance to receive axillary node dissection or sentinel lymph node biopsy. Figure 2.4. Women under age 70 treated for breast cancer with breast-conserving surgery who received radiation therapy within 1 year of diagnosis, by race and ethnicity, 2004-2008 Percent 100 White Black Asian NHOPI AI/AN 2008 Achievable Benchmark: 93% 90 80 70 Percent 100 90 80 70 Total Non-Hispanic White Hispanic 2008 Achievable Benchmark: 93% Chapter 2 Cancer 60 60 50 Z 0 2004 2005 2006 2007 2008 50 Z 0 2004 2005 2006 2007 2008 Key: NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native. Source: Commission on Cancer, American College of Surgeons and American Cancer Society, National Cancer Data Base, 2004- 2008. Denominator: Women under age 70 undergoing breast-conserving surgery. n Between 2004 and 2008, the percentage of women under age 70 treated for breast cancer with breast-conserving surgery who received radiation therapy within 1 year of diagnosis did not change significantly overall or for any racial or ethnic group (Figure 2.4). n In all years, Black and Asian women were less likely than White women and Hispanic women were less likely than non-Hispanic White women to receive radiation therapy. n The 2008 top 5 State achievable benchmark was 93%. vii There is no evidence of progress toward the benchmark by any racial or ethnic group. vii The top 5 States that contributed to the achievable benchmark are New Hampshire, North Dakota, Oregon, South Dakota, and Wisconsin. National Healthcare Disparities Report, 2011 55
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NATIONAL HEALTHCARE DISPARITIES REP
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Acknowledgments The NHQR and NHDR a
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National Healthcare Disparities Rep
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Highlights New this year, the Highl
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Care Coordination Importance Chapte
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U.S. Department of Health and Human
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