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Underuse of Radiation Therapy After Breast Conservation Surgery in Puerto Rico: A Puerto Rico Central Cancer Registry-Health Insurance Linkage Database Study.
Chance, William W; Ortiz-Ortiz, Karen J; Liao, Kai-Ping; Zavala Zegarra, Diego E; Stauder, Michael C; Giordano, Sharon H; Tortolero-Luna, Guillermo; Guadagnolo, B Ashleigh.
Afiliação
  • Chance WW; William W. Chance, Kai-Ping Liao, Michael C. Stauder, Sharon H. Giordano, and B. Ashleigh Guadagnolo, The University of Texas MD Anderson Cancer Center, Houston, TX; and Karen J. Ortiz-Ortiz, Diego E. Zavala Zegarra, and Guillermo Tortolero-Luna, University of Puerto Rico Comprehensive Cancer Center
  • Ortiz-Ortiz KJ; William W. Chance, Kai-Ping Liao, Michael C. Stauder, Sharon H. Giordano, and B. Ashleigh Guadagnolo, The University of Texas MD Anderson Cancer Center, Houston, TX; and Karen J. Ortiz-Ortiz, Diego E. Zavala Zegarra, and Guillermo Tortolero-Luna, University of Puerto Rico Comprehensive Cancer Center
  • Liao KP; William W. Chance, Kai-Ping Liao, Michael C. Stauder, Sharon H. Giordano, and B. Ashleigh Guadagnolo, The University of Texas MD Anderson Cancer Center, Houston, TX; and Karen J. Ortiz-Ortiz, Diego E. Zavala Zegarra, and Guillermo Tortolero-Luna, University of Puerto Rico Comprehensive Cancer Center
  • Zavala Zegarra DE; William W. Chance, Kai-Ping Liao, Michael C. Stauder, Sharon H. Giordano, and B. Ashleigh Guadagnolo, The University of Texas MD Anderson Cancer Center, Houston, TX; and Karen J. Ortiz-Ortiz, Diego E. Zavala Zegarra, and Guillermo Tortolero-Luna, University of Puerto Rico Comprehensive Cancer Center
  • Stauder MC; William W. Chance, Kai-Ping Liao, Michael C. Stauder, Sharon H. Giordano, and B. Ashleigh Guadagnolo, The University of Texas MD Anderson Cancer Center, Houston, TX; and Karen J. Ortiz-Ortiz, Diego E. Zavala Zegarra, and Guillermo Tortolero-Luna, University of Puerto Rico Comprehensive Cancer Center
  • Giordano SH; William W. Chance, Kai-Ping Liao, Michael C. Stauder, Sharon H. Giordano, and B. Ashleigh Guadagnolo, The University of Texas MD Anderson Cancer Center, Houston, TX; and Karen J. Ortiz-Ortiz, Diego E. Zavala Zegarra, and Guillermo Tortolero-Luna, University of Puerto Rico Comprehensive Cancer Center
  • Tortolero-Luna G; William W. Chance, Kai-Ping Liao, Michael C. Stauder, Sharon H. Giordano, and B. Ashleigh Guadagnolo, The University of Texas MD Anderson Cancer Center, Houston, TX; and Karen J. Ortiz-Ortiz, Diego E. Zavala Zegarra, and Guillermo Tortolero-Luna, University of Puerto Rico Comprehensive Cancer Center
  • Guadagnolo BA; William W. Chance, Kai-Ping Liao, Michael C. Stauder, Sharon H. Giordano, and B. Ashleigh Guadagnolo, The University of Texas MD Anderson Cancer Center, Houston, TX; and Karen J. Ortiz-Ortiz, Diego E. Zavala Zegarra, and Guillermo Tortolero-Luna, University of Puerto Rico Comprehensive Cancer Center
J Glob Oncol ; 4: 1-9, 2018 09.
Article em En | MEDLINE | ID: mdl-30241162
PURPOSE: To identify rates of postoperative radiation therapy (RT) after breast conservation surgery (BCS) in women with stage I or II invasive breast cancer treated in Puerto Rico and to examine the sociodemographic and health services characteristics associated with variations in receipt of RT. METHODS: The Puerto Rico Central Cancer Registry-Health Insurance Linkage Database was used to identify patients diagnosed with invasive breast cancer between 2008 and 2012 in Puerto Rico. Claims codes identified the type of surgery and the use of RT. Logistic regression models were used to examine the independent association between sociodemographic and clinical covariates. RESULTS: Among women who received BCS as their primary definitive treatment, 64% received adjuvant RT. Significant predictors of RT after BCS included enrollment in Medicare (odds ratio [OR], 2.14; 95% CI, 1.46 to 3.13; P ≤ .01) and dual eligibility for Medicare and Medicaid (OR, 1.61; 95% CI, 1.14 to 2.27; P < .01). In addition, it was found that RT was more likely to have been received in certain geographic locations, including the Metro-North (OR, 2.20; 95% CI, 1.48 to 3.28; P < .01), North (OR, 1.78; 95% CI, 1.20 to 2.64; P < .01), West (OR, 4.04; 95% CI, 2.61 to 6.25; P < .01), and Southwest (OR, 2.79; 95% CI, 1.70 to 4.59; P < .01). Furthermore, patients with tumor size > 2.0 cm and ≤ 5.0 cm (OR, 0.61; 95% CI, 0.40 to 0.93; P = .02) and those with tumor size > 5.0 cm (OR, 0.37; 95% CI, 0.15 to 0.92; P = .03) were found to be significantly less likely to receive RT. CONCLUSION: Underuse of RT after BCS was identified in Puerto Rico. Patients enrolled in Medicare and those who were dually eligible for Medicaid and Medicare were more likely to receive RT after BCS compared with patients with Medicaid alone. There were geographic variations in the receipt of RT on the island.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Mau Uso de Serviços de Saúde Tipo de estudo: Prognostic_studies Limite: Adult / Aged / Female / Humans / Middle aged País/Região como assunto: Caribe / Puerto rico Idioma: En Revista: J Glob Oncol Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Mau Uso de Serviços de Saúde Tipo de estudo: Prognostic_studies Limite: Adult / Aged / Female / Humans / Middle aged País/Região como assunto: Caribe / Puerto rico Idioma: En Revista: J Glob Oncol Ano de publicação: 2018 Tipo de documento: Article