Disentangling the effects of race on XXXX treatment.

@entity1 @entity440 @entity0 @entity5 @entity3004
BACKGROUND: @entity3004 ( @entity3004 ) have higher mortality from @entity0 compared with white Americans (WA). Studies using population-based @entity5 registries have attributed this to disparities in treatment after normalizing the @entity3004 and WA populations for differences in disease stage. However, those studies were hampered by lack of comorbidity data and limited information about systemic treatments. The objective of the current study was to investigate racial disparities in @entity0 treatment by conducting a comprehensive medical records review of @entity1 who were diagnosed with @entity0 at the Karmanos @entity5 Institute (KCI) in Detroit, Michigan. METHODS: The study cohort consisted of 651 @entity1 who were diagnosed with primary @entity0 between 1990 and 1996 at KCI. Multivariable logistic regression analysis controlling for sociodemographic factors, @entity5 characteristics, comorbidities, and health insurance status was used to assess whether there were differences between WA and @entity3004 in the receipt of breast-conserving surgery (BCS), radiation, @entity440 , and chemotherapy. RESULTS: There was no significant difference between WA and @entity3004 in the receipt of BCS versus mastectomy. @entity1 with @entity5 who were enrolled in government insurance plans underwent mastectomy more often (vs BCS plus radiation) compared with @entity1 who were enrolled in nongovernment plans. The rates of receipt of @entity440 and chemotherapy were similar for local-stage WA and local-stage @entity3004 . However, WA were more likely to receive @entity440 and/or chemotherapy for regional-stage disease. Married @entity1 with regional disease were more likely to receive chemotherapy than nonmarried @entity1 . CONCLUSIONS: The results from this study may be used to target educational interventions to improve the use of adjuvant therapies among @entity3004 @entity1 who have regional-stage disease.
