How to Increase Appropriate Use of Breast-Conserving Therapy - Greater Access to Radiation Oncology Services or Physician Education
Abstract
Breast conserving therapy with radiation (BCT) is underutilized in the treatment of stage I and II breast cancer. This project examines the degree to which distance to radiation therapy and the training and practice style of surgeons contribute to this underuse of BCT in elderly women, especially those living in rural areas. A comprehensive database linking information from the Seattle-Puget Sound Surveillance, Epidemiology, and End Results Program, Medicare part B claims, the American Medical Association Masterfile, and the American Board of Medical Specialties has been created for the study analyses. We will define cohorts of women based on 1) their distance from radiation therapy services, 2) their surgeons' characteristics, such as board certification status, gender, and time in practice, and 3) their consultation with medical and radiation oncologists prior to surgery. We will examine rates of use of BCT in these cohorts while controlling for patient characteristics such as age, co-morbidity, race, and marital status. The results of this study will be used to identify potentially modifiable causes for underuse of BCT and to determine whether interventions to increase availability of BCT should focus on physician education, public education, or improving access to radiation therapy services.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 1999
- Accession Number
- ADA381254
Entities
People
- Laura M. Baldwin
Organizations
- University of Washington