A contributor to persistent racial/ethnic and socioeconomic disparities is limited understanding of the care provided to minority and disadvantaged populations.

To address this, researchers evaluated the quality of breast cancer care in 2 large states, New York and California, based on 34 quality measures. The study was published online ahead of print in Cancer.1

The researchers evaluated breast cancer care in New York and California to better understand the disparities experienced by African Americans, Hispanics, Asian/Pacific Islanders (APIs), and Medicaid enrollees.

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They assessed overuse and underuse of surgery, radiation, chemotherapy, and hormone therapy based on 34 quality measures using statewide cancer registry data for 80 436 women in New York and 121 233 women in California.

Overall concordance was 76% and 87% for underuse measures and overuse measures, respectively, with 35% of those in New York and 33% of those in California receiving care concordant with all relevant measures.

Results showed disparities experienced by the racial/ethnic groups were not the same across the states. African Americans were less likely to receive recommended surgery, radiation, and hormone therapy compared with whites; and Hispanics and APIs were usually more likely to receive recommended chemotherapy.

Likelihood of receiving all recommended treatments, except chemotherapy, was lower among Medicaid enrollees. Overuse of hormone therapy and axillary surgery was evident but not associated with race/ethnicity or Medicaid enrollment.

The researchers conclude, “Remediating these problems will require prioritizing low-performing measures and targeting high-risk populations, possibly in different ways for different regions.”


1. Hassett MJ, Schymura MJ, Chen K, Boscoe FP, Gesten FC, Schrag D. Variation in breast cancer care quality in New York and California based on race/ethnicity and Medicaid enrollment [published online ahead of print November 4, 2015]. Cancer. doi:10.1002/cncr.29777.