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Emerson MA, Reeder-Hayes KE, Tipaldos HJ, et al. Integrating biology and access to care in addressing breast cancer disparities: 25 years' research experience in the Carolina Breast Cancer Study. Curr Breast Cancer Rep. 2020;12(3):149-160doi: 10.1007/s12609-020-00365-0.
Emerson, M. A., Reeder-Hayes, K. E., Tipaldos, H. J., Bell, M. E., Sweeney, M. R., Carey, L. A., Earp, H. S., Olshan, A. F., & Troester, M. A. (2020). Integrating biology and access to care in addressing breast cancer disparities: 25 years' research experience in the Carolina Breast Cancer Study. Current breast cancer reports, 12(3), 149-160. https://doi.org/10.1007/s12609-020-00365-0
Emerson, Marc A, et al. "Integrating biology and access to care in addressing breast cancer disparities: 25 years' research experience in the Carolina Breast Cancer Study." Current breast cancer reports vol. 12,3 (2020): 149-160. doi: https://doi.org/10.1007/s12609-020-00365-0
Emerson MA, Reeder-Hayes KE, Tipaldos HJ, Bell ME, Sweeney MR, Carey LA, Earp HS, Olshan AF, Troester MA. Integrating biology and access to care in addressing breast cancer disparities: 25 years' research experience in the Carolina Breast Cancer Study. Curr Breast Cancer Rep. 2020 Sep;12(3):149-160. doi: 10.1007/s12609-020-00365-0. Epub 2020 May 14. PMID: 33815665; PMCID: PMC8011652.
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Curr Breast Cancer Rep. 2020 Sep;12(3):149-160. doi: 10.1007/s12609-020-00365-0. Epub 2020 May 14.

Integrating biology and access to care in addressing breast cancer disparities: 25 years' research experience in the Carolina Breast Cancer Study.

Current breast cancer reports

Marc A Emerson, Katherine E Reeder-Hayes, Heather J Tipaldos, Mary E Bell, Marina R Sweeney, Lisa A Carey, H Shelton Earp, Andrew F Olshan, Melissa A Troester

Affiliations

  1. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA.
  2. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

PMID: 33815665 PMCID: PMC8011652 DOI: 10.1007/s12609-020-00365-0

Abstract

PURPOSE OF REVIEW: To review research on breast cancer mortality disparities, emphasizing research conducted in the Carolina Breast Cancer Study, with a focus on challenges and opportunities for integration of tumor biology and access characteristics across the cancer care continuum.

RECENT FINDINGS: Black women experience higher mortality following breast cancer diagnosis, despite lower incidence compared to white women. Biological factors, such as stage at diagnosis and breast cancer subtypes, play a role in these disparities. Simultaneously, social, behavioral, environmental, and access to care factors are important. However, integrated studies of biology and access are challenging and it is uncommon to have both data types available in the same study population. The central emphasis of Phase 3 of the Carolina Breast Cancer Study, initiated in 2008, was to collect rich data on biology (including germline and tumor genomics and pathology) and health care access in a diverse study population, with the long term goal of defining intervention opportunities to reduce disparities across the cancer care continuum.

SUMMARY: Early and ongoing research from CBCS has identified important interactions between biology and access, leading to opportunities to build greater equity. However, sample size, population-specific relationships among variables, and complexities of treatment paths along the care continuum pose important research challenges. Interdisciplinary teams, including experts in novel data integration and causal inference, are needed to address gaps in our understanding of breast cancer disparities.

Keywords: Breast cancer; access to health care; cancer care continuum; data integration; racial disparities

Conflict of interest statement

Conflict of Interest Marc A. Emerson, Katherine E. Reeder-Hayes, Heather J. Tipaldos, Mary E. Bell, Marina R. Sweeney, Lisa A. Carey, H. Shelton Earp, Andrew F. Olshan and Melissa A. Troester declare

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