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Racial disparities in early stage breast cancer treatment
Descriptive
TitleInfo
Title
Racial disparities in early stage breast cancer treatment
Name
(type = personal)
NamePart
(type = family)
George
NamePart
(type = given)
Prethibha A.
NamePart
(type = date)
1975-
DisplayForm
Prethibha George
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(authority = RULIB)
author
Name
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KITAW
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KITAW DEMISSIE
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Advisory Committee
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chair
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RHOADS
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GEORGE
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GEORGE RHOADS
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Advisory Committee
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internal member
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LIN
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YONG
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YONG LIN
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Advisory Committee
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internal member
Name
(type = personal)
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(type = family)
West
NamePart
(type = given)
Bernadette
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Bernadette West
Affiliation
Advisory Committee
Role
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(authority = RULIB)
internal member
Name
(type = personal)
NamePart
(type = family)
Hirshfield
NamePart
(type = given)
Kim
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Kim Hirshfield
Affiliation
Advisory Committee
Role
RoleTerm
(authority = RULIB)
outside member
Name
(type = personal)
NamePart
(type = family)
Azu
NamePart
(type = given)
Michelle
DisplayForm
Michelle Azu
Affiliation
Advisory Committee
Role
RoleTerm
(authority = RULIB)
outside member
Name
(type = corporate)
NamePart
Rutgers University
Role
RoleTerm
(authority = RULIB)
degree grantor
Name
(type = corporate)
NamePart
Graduate School - New Brunswick
Role
RoleTerm
(authority = RULIB)
school
TypeOfResource
Text
Genre
(authority = marcgt)
theses
OriginInfo
DateCreated
(qualifier = exact)
2012
DateOther
(qualifier = exact);
(type = degree)
2012-10
CopyrightDate
(qualifier = exact)
2012
Place
PlaceTerm
(type = code)
xx
Language
LanguageTerm
(authority = ISO639-2b);
(type = code)
eng
Abstract
(type = abstract)
Introduction: Appropriate treatment disparity and delay in receipt of treatment are possible reasons that contribute to shorter survival in African-American (AA) breast cancer patients compared to their White counterparts. Specific Aims: In early stage breast cancer: 1) determine if racial differences exist in treatment, 2) examine racial disparity of delays in diagnosis and treatment initiation and explore factors that predicted delay in the overall population and by race, 3) examine factors that influenced the choice between mastectomy and breast-conserving surgery (BCS) and whether these factors differed by race. Methods: Newly diagnosed invasive breast cancer patients during 2005-2010 were identified in seven eastern New Jersey counties through rapid case ascertainment. For each AA woman 18-85 years of age, a white woman was randomly selected (± 5 years of age and from same county). Two data collection methods took place: medical chart review (Aims 1 & 2) and semi-structured interviews (Aim 3). Multivariable binomial and linear regression models were conducted to explore associations between race and outcomes (receipt of standard treatment; diagnosis and treatment delay). Results: In Aim 1, AAs tended not to receive optimal treatment compared to whites (RR: 1.60; 95% CI: .94, 2.71). Aim 2 demonstrated that AA women experienced longer time to diagnosis and surgical treatment. The geometric mean (95% CI) for whites and AAs in time to diagnosis was 35 (31, 40) and 47 (41, 54); time to surgery was 28 (26, 30) and 33 (30, 35) respectively. Aim 3 demonstrated that health issues that interfered with physical/social activities influenced AAs to receive mastectomy compared to BCS (RR: 1.68; 95% CI: 1.01, 2.77). Conclusion: We observed racial differences in receipt of optimal treatment (after controlling clinical factors) and took longer time to diagnosis and treatment for early stage breast cancer among AAs compared to white women. These differences could contribute to the observed poor survival in AAs with breast cancer. Also AAs listed previous health issues as an influencing factor in the surgical treatment they received. The findings suggest that interventions are needed to eliminate barriers that contribute to the observed disparity and to help narrow the racial gap in survival rates.
Subject
(authority = RUETD)
Topic
Public Health
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TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Identifier
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ETD
Identifier
ETD_4290
PhysicalDescription
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electronic resource
InternetMediaType
application/pdf
InternetMediaType
text/xml
Extent
ix, 121 p. : ill.
Note
(type = degree)
Ph.D.
Note
(type = bibliography)
Includes bibliographical references
Note
(type = vita)
Includes vita
Note
(type = statement of responsibility)
by Prethibha A. George
Subject
(authority = ETD-LCSH)
Topic
Breast--Cancer--Treatment
Subject
(authority = ETD-LCSH)
Topic
African American women--Health and hygiene
Subject
(authority = ETD-LCSH)
Topic
Women, White--Health and hygiene
Subject
(authority = ETD-LCSH)
Topic
African American women--Medical care
Subject
(authority = ETD-LCSH)
Topic
Discrimination in medical care--United States
Identifier
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http://hdl.rutgers.edu/1782.1/rucore10001600001.ETD.000066742
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TitleInfo
Title
Graduate School - New Brunswick Electronic Theses and Dissertations
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rucore19991600001
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NjNbRU
Identifier
(type = doi)
doi:10.7282/T3F18XJV
Genre
(authority = ExL-Esploro)
ETD doctoral
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Rights
RightsDeclaration
(ID = rulibRdec0006)
The author owns the copyright to this work.
RightsHolder
(type = personal)
Name
FamilyName
George
GivenName
Prethibha
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime
(encoding = w3cdtf);
(qualifier = exact);
(point = start)
2012-09-26 09:26:12
AssociatedEntity
Name
Prethibha George
Role
Copyright holder
Affiliation
Rutgers University. Graduate School - New Brunswick
AssociatedObject
Type
License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
RightsEvent
DateTime
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(qualifier = exact);
(point = start)
2012-10-31
DateTime
(encoding = w3cdtf);
(qualifier = exact);
(point = end)
2014-10-31
Type
Embargo
Detail
Access to this PDF has been restricted at the author's request. It will be publicly available after October 31st, 2014.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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Technical
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541696
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