Differences in physician recommendations account for residual racial differences in BRCA1/2 testing among women with breast cancer, despite the fact that black and white patients tend to see different surgeons and oncologists. This according to a population-based study of 3,016 women (69% black, 31% white) aged 18 to 64 years and diagnosed with invasive breast cancer between 2007 and 2009. The study also included 808 medical oncologists, and 732 surgeons. Researchers found:
• Black women were less likely to undergo BRCA1/2 testing than white women (OR=0.40).
• This difference was attenuated but not eliminated by adjustment for mutation risk, clinical factors, socioeconomic characteristics, and attitudes about testing (OR=0.66).
• The care of black and white women was highly segregated across surgeons and oncologists.
• Black women were less likely to report that they had received physician recommendation for BRCA1/2 testing, even after adjusting for mutation risk (OR=0.66).
• Adjusting for physician recommendation further lessened the testing disparity.
Citation: McCarthy AM, Bristol M, Domchek SM, et al. Health care segregation, physician recommendation, and racial disparities in BRCA1/2 testing among women with breast cancer. [Published online ahead of print May 9, 2016]. J Clin Oncol. doi:10.1200/JCO.2015.66.0019.