Abstract C063: Using a disparities dashboard to identify racial/ethnic differences in breast cancer treatment: Implications for improving cancer care delivery
Authors: Edmonds Megan , Agarwal Parul , Balija Tara , Smith Cardinale , Bickell Nina 
Published: September 2024

Abstract
Purpose: The use of a cancer dashboard to assess and inform real time assessments of the timing of surgery and systemic treatment by race/ethnicity may be used to address delays in cancer treatment. Yet, the utility of cancer dashboards in cancer settings are unclear as electronic medical record (EMR) stage data are unstructured. We investigated whether a cancer disparities dashboard can be used to assess racial/ethnic differences in the first line of breast cancer treatment and timeliness of breast cancer surgery. Methods: A disparities cancer dashboard was built using data from the tumor registry and the EMR’s Data Warehouse. Key fields assessing patient race/ethnicity, cancer stage, receptor status, surgery type, treatments received and dates of surgery were collected. This retrospective analysis included women diagnosed with a new primary breast cancer who underwent definitive surgery at an urban Hospital (2010-2020). We defined delays as &gt;8 weeks to treatment initiation, and delay to breast surgery as &gt; 6 weeks from diagnosis. Chi-square and t tests were used to assess independent variables (e.g., stage, age) by race/ethnicity. Patient-level multivariable logistic regression was used to evaluate the association between race/ethnicity and delays to initiation of first treatment and surgical delays. Results: Of 8,403 women identified (46.5% non-Hispanic White, 17.7% Black, 16.9% Hispanic), 66% had stage I cancer, 72% had estrogen receptor cancer. 18.6% of the sample had delays to first treatment modality and 42.6% experienced delays to breast surgery. After adjusting for stage, age and receptor status Black patients compared to non-Hispanic White patients had the greatest likelihood of delayed first treatment (OR: 2.09; 95% CI:1.7-2.5) or surgery delays (OR:1.76; 95% CI:1.5-2.0). With regards to clinical/sociodemographic factors younger patients (22-39 vs. 40-64; p&lt;0.001), mastectomy surgery type (vs lumpectomy; p=0.031), higher stage (stage 3 vs.1; p&lt;0.0001), HER2 + and TNBC receptor status (vs. ER+; p&lt;0.0001) were more likely to experience surgery delays. Conclusions: Given persistent breast cancer survival disparities, health IT strategies are needed to help reduce disparities. A disparities dashboard can be used to assess differences in timeliness of care when treatment can still affect outcomes. These data can be used to inform quality initiatives to improve cancer care delivery for at-risk patient populations who experience worse cancer outcomes.
Citation Format: Megan Edmonds, Parul Agarwal, Tara Balija, Cardinale Smith, Nina Bickell. Using a disparities dashboard to identify racial/ethnic differences in breast cancer treatment: Implications for improving cancer care delivery [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C063.