Presented as an oral podium presentation at the 2012 American Society for Clinical Oncology Annual Meeting; June 1-5, 2012; Chicago, IL.
What factors influence minority use of National Cancer Institute-designated cancer centers?
Article first published online: 21 OCT 2013
© 2013 American Cancer Society
Volume 120, Issue 3, pages 399–407, 1 February 2014
How to Cite
Huang, L. C., Ma, Y., Ngo, J. V. and Rhoads, K. F. (2014), What factors influence minority use of National Cancer Institute-designated cancer centers?. Cancer, 120: 399–407. doi: 10.1002/cncr.28413
We thank Patricia Carbajales for her help with the GIS geocoding and spatial analysis.
- Issue published online: 22 JAN 2014
- Article first published online: 21 OCT 2013
- Manuscript Accepted: 5 SEP 2013
- Manuscript Revised: 21 AUG 2013
- Manuscript Received: 21 JUN 2013
- health care disparities;
- colorectal cancer;
- National Cancer Institute-designated cancer centers;
- socioeconomic factors;
- access to care;
- insurance coverage
National Cancer Institute (NCI) cancer centers provide high-quality care and are associated with better outcomes. However, racial and ethnic minority populations tend not to use these settings. The current study sought to understand what factors influence minority use of NCI cancer centers.
A data set containing California Cancer Registry (CCR) data linked to patient discharge abstracts identified all patients with colorectal cancer (CRC) who were treated from 1996 through 2006. Multivariable models were generated to predict the use of NCI settings by race. Geographic proximity to an NCI center and patient sociodemographic and clinical characteristics were assessed.
Approximately 5% of all identified patients with CRC (n = 79,231) were treated in NCI settings. The median travel distance for treatment for all patients in all hospitals was ≤ 5 miles. A higher percentage of minorities lived near an NCI cancer center compared with whites. A baseline multivariable model predicting use showed a negative association between Hispanic ethnicity and NCI center use (odds ratio, 0.71; 95% confidence interval, 0.64-0.79). Asian/Pacific Islander patients were more likely to use NCI centers (odds ratio, 1.41; 95% confidence interval, 1.28-1.54). There was no difference in use noted among black patients. Increasing living distance from an NCI cancer center was found to be predictive of lower odds of use for all populations. Medicare and Medicaid insurance statuses were positively associated with NCI center use. Neighborhood-level education was found to be a more powerful predictor of NCI use than poverty or unemployment.
Select minority groups underuse NCI cancer centers for CRC treatment. Sociodemographic factors and proximity to NCI centers are important predictors of use. Interventions to address these factors may improve minority attendance to NCI cancer centers for care. Cancer 2014;120:399–407. © 2013 American Cancer Society.