Evaluating disparities in inpatient surgical cancer care among American Indian/Alaska Native patients

Vlad V. Simianu, Arden M. Morris, Thomas K. Varghese, Michael P. Porter, Jeffrey A. Henderson, Dedra S. Buchwald, David R. Flum, Sara H. Javid

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background American Indian/Alaska Native (AI/AN) patients with cancer have the lowest survival rates of all racial and ethnic groups, possibly because they are less likely to receive “best practice” surgical care than patients of other races. Methods Prospective cohort study comparing adherence with generic and cancer-specific guidelines on processes of surgical care between AI/AN and non-Hispanic white (NHW) patients in Washington State (2010 to 2014) was conducted. Results A total of 156 AI/AN and 6,030 NHW patients underwent operations for 10 different cancers, and had similar mean adherence to generic surgical guidelines (91.5% vs 91.9%, P =.57). AI/AN patients with breast cancer less frequently received preoperative diagnostic core needle biopsy (81% vs 94%, P =.004). AI/AN patients also less frequently received care adherent to prostate cancer-specific guidelines (74% vs 92%, P =.001). Conclusion Although AI/ANs undergoing cancer operations in Washington receive similar overall best practice surgical cancer care to NHW patients, there remain important, modifiable disparities that may contribute to their lower survival.

Original languageEnglish (US)
Pages (from-to)297-304
Number of pages8
JournalAmerican journal of surgery
Volume212
Issue number2
DOIs
StatePublished - Aug 1 2016

Bibliographical note

Funding Information:
This research was performed under the auspices of the Collaborative to Improve Native Cancer Outcomes, a P50 program project sponsored by the National Cancer Institute. Research reported in this publication was supported by the National Cancer Institute (P50 CA148110) and the National Institute of Diabetes and Digestive and Kidney Diseases (T32 DK070555). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. The Surgical Care and Outcomes Assessment Program (SCOAP) is a Coordinated Quality Improvement Program of the Foundation for Health Care Quality. The Comparative Effectiveness Research Translation Network, a program of the University of Washington, provided research and analytic support to SCOAP. We thank Raymond Harris, PhD, University of Washington School of Public Health, for editing assistance.

Keywords

  • American Indian/Alaska Natives
  • Cancer
  • Process of care
  • Surgery

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