Abstract C116: Racial/ethnic disparities in perceived quality of breast cancer survivorship care among older women by general health status: A SEER-CAHPS study
Authors: Dibble Kate E. , Deng Zhengyi , Connor Avonne E. 
Published: January 2023

Abstract
Purpose: We aimed to outline the extent of racial/ethnic disparities in perceived quality of cancer survivorship care among older breast cancer survivors in the United States. Methods: We utilized the National Cancer Institute’s Surveillance, Epidemiology, and End Results program (SEER) and the Center for Medicare and Medicaid Services Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data linkage from 2000-2019. 19,017 female breast cancer survivors aged ≥65 years at survey with a prior diagnosis of primary invasive breast cancer were included. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression to determine the relationship between race/ethnicity (non-Hispanic white [NHW; referent], non-Hispanic Black [NHB], non-Hispanic Asian [NHA], Hispanic) and perceived quality of survivorship care (excellent in Getting Care Quickly, Getting Needed Care, Physician Communication, Getting Needed Prescription Drugs, and Overall Care, Health Plan, and Physician ratings), and usually/always having Enough Time with Physician, overall and by perceived general health status (excellent/very good, good, fair/poor). Results: Most survivors were NHW (78.1%) while the minority were NHB (8.1%), NHA (6.5%), or Hispanic (6.2%). Survivors reported an average of 76.3 years at survey (SD=7.14) and 4.65 years (SD=3.51) since diagnosis. Overall, NHB survivors were significantly less likely to report excellent for Overall Care (aOR, 0.80, 95% CI, 0.71-0.91) and usually/always having Enough Time with Physician (aOR, 0.74, 95% CI, 0.58-0.93) compared to NHW survivors. NHA survivors were significantly less likely to report excellent Getting Care Quickly (aOR, 0.75, 95% CI, 0.63-0.88), Getting Needed Care (aOR, 0.79, 95% CI, 0.63-0.99), Physician Communication (aOR, 0.84, 95% CI, 0.73-0.97), and Overall Care rating (aOR, 0.76, 95% CI, 0.67-0.87) compared to NHW survivors. The aORs for Hispanic survivors varied depending on outcome. When stratified by general health status, NHB compared to NHW survivors were significantly more likely (aOR, 1.30, 95% CI, 1.05-1.62) to report excellent in Getting Needed Care among those who reported good general health, but this disparity was not observed among those who reported excellent/very good general health (p-interaction=0.04). Compared to NHW survivors, NHB were significantly more likely (aOR, 1.54, 95% CI, 1.14-2.08) to report excellent Health Plan ratings among those who reported excellent/very good general health but not among those who reported good (p-interaction=0.03) or fair/poor general health (p-interaction=0.01). There were no significant interactions between general health status and NHA or Hispanic group for any outcome. Conclusion: These findings can be used to inform future interventions, care, and physician education throughout breast cancer survivorship.
Citation Format: Kate E. Dibble, Zhengyi Deng, Avonne E. Connor. Racial/ethnic disparities in perceived quality of breast cancer survivorship care among older women by general health status: A SEER-CAHPS study [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C116.