Tracking system ensures women with breast cancer see oncologists and receive additional treatment
Research Activities, May 2009, No. 345
After surgery, women diagnosed with early stage breast cancer often benefit from treatment with chemotherapy, radiation, or hormonal therapy. For this reason, surgeons typically refer these patients to oncologists. Unfortunately, some women, especially blacks and Hispanics, are not seen by the oncologist, though their surgeons assume they are. To keep these women from falling through the cracks, New York researchers developed a tracking system to find out if patients visited an oncologist and feed that information back to the surgeon so they could follow up with patients who did not connect with oncologists.
Researchers compared the treatment of 639 women with early stage breast cancer who were seen at 6 New York City hospitals between January 1999 and December 2000 with 300 women who were seen between September 2004 and March 2006, the time period in which the tracking system was used. Rates of oncology consultations, chemotherapy, and hormonal therapy were higher for all women after the tracking system was in place.
The authors state that their tracking system eliminated the racial disparity that existed for black and Hispanic women regarding the underuse of radiation, chemotherapy, and hormonal therapy. For example, after the tracking system was implemented, underuse of radiotherapy declined from 23 to 10 percent, underuse of chemotherapy decreased from 26 to 6 percent, and underuse of hormonal therapy diminished from 27 to 11 percent for black and Hispanic women. The authors suggest two ways to ensure patients receive proper care for early stage breast cancer. The first is by ensuring tumor registry personnel follow up with patients to determine if they visited oncologists. The second is having insurers require an oncology consultation for all patients diagnosed with invasive breast cancer to make sure these women receive appropriate treatment. This study was funded in part by the Agency for Healthcare Research and Quality (HS10859).
See "A tracking and feedback registry to reduce racial disparities in breast cancer care," by Nina A. Bickell, M.D., M.P.H., Kruti Shastri, M.P.H., Kezhen Fei, M.S., and others in the December 3, 2008, Journal of the National Cancer Institute 100(23), pp. 1717-1723.