Abstract B008: South Carolina's National Breast and Cervical Cancer Early Detection Program narrows the gap in South Carolina breast cancer disparities
Authors: Adams Swann Arp , Truman Samantha C. , Babatunde Oluwole , Felder Tisha M. , Eberth Jan M. , Heiney Sue P. , Alvarado Christian R. , Hebert James R. 
Published: August 2020

Background: The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides screening for breast cancer and, ultimately, navigation to treatment services for women who are economically disadvantaged and unable to afford such services. Consequently, SC's NBCCEDP, the Best Chance Network (BCN), is crucial in helping to address the excess burden of breast cancer mortality experienced by black women as well as those with lower socio-economic status.

Purpose: The purpose of this investigation was to compare time to each treatment modality (surgery, chemotherapy, radiation therapy, and hormonal therapy) between BCN participants and participants in Medicaid or a private payor insurance plan.

Methods: SC Central Cancer Registry data (2002-2010) were linked to administrative data from Medicaid or another private payor insurance plan. Eligibility criteria included white or black race and continuous enrollment in their respective insurance plan for 3 years post diagnosis. Time from diagnosis to date of first surgery, chemotherapy, radiation therapy, and hormonal therapy were calculated from administrative data files. T-tests and chi-square tests were used to compare descriptive statistics as appropriate. Cox proportional hazards models were used to assess the relationship among BCN participation, treatment times, and survival.

Results: No significant differences were noted for time to surgery, chemotherapy, or hormonal therapy between BCN participants and the rest of the cohort. Interestingly, significant differences were noted between the two groups for time to radiation therapy (178 days for BCN vs. 150 days for the rest of the cohort, p=0.05). In multivariable Cox models, there were no breast cancer survival differences by BCN participation (p=0.94) after adjusting for age, stage, and insurance type. Among BCN participants, Cox models did not demonstrate any relationship between treatment time (for any treatment type) or race with survival after adjusting for age and stage.

Conclusion: This work provides evidence that emphasizes the important role that state programs such as the BCN play in navigating women into timely treatment and eliminating the disparity that is often seen for the receipt of breast cancer treatment among economically disadvantaged women. Furthermore, this work highlights the potential for these programs to decrease mortality disparities experienced by black women in SC.

Citation Format: Swann Arp Adams, Samantha C. Truman, Oluwole Babatunde, Tisha M. Felder, Jan M. Eberth, Sue P. Heiney, Christian R. Alvarado, James R. Hebert. South Carolina's National Breast and Cervical Cancer Early Detection Program narrows the gap in South Carolina breast cancer disparities [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B008.