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Bone Mineral Density Testing Disparities Among Patients With Breast Cancer Prescribed Aromatase Inhibitors. J Natl Compr Canc Netw 2016 07;14(7):875-80 PMID: 27407128

Pubmed ID

27407128

Abstract

OBJECTIVES: Aromatase inhibitors (AIs) are standard adjuvant therapy for postmenopausal women with early-stage, estrogen receptor-positive breast cancer. We designed our study to determine whether women initiating adjuvant therapy with an AI underwent baseline bone mineral density testing, as well as what factors predicted adherence with testing guidelines.

METHODS: Medicare Parts A, B, and D claims were used to identify a cohort of women aged 67 years and older with incident breast cancer in 2006 and 2007 who started AI therapy. Medicare claims provided information about bone density testing, as well as demographic and other treatment data through 2012. We also ascertained which patients were treated with bisphosphonates and studied the relationship of bisphosphonate therapy with bone density testing.

RESULTS: Approximately two-thirds of patients had baseline bone density testing. Older age, comorbidity, low income, and black race were associated with lower rates of baseline bone density testing. Testing rates decreased substantially with increasing age from 73% for women aged 67 to 70 years to 51% for those 85 years of age and older (adjusted odds ratio for not being tested, 2.48 [Cl, 2.17-2.82]). The proportion of women who had neither bone density testing nor bisphosphonate therapy increased with age as well.

CONCLUSIONS: Despite the importance of age as a risk factor for fractures, older women starting treatment with AIs for treatment of breast cancer are less likely to undergo recommended bone density assessment.

Author List

Charlson J, Smith EC, Smallwood AJ, Laud PW, Neuner JM

Authors

John A. Charlson MD Associate Professor in the Medicine department at Medical College of Wisconsin
Purushottam W. Laud PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Joan Neuner MD, MPH Associate Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-84978910683   2 Citations

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Aromatase Inhibitors
Bone Density Conservation Agents
Breast Neoplasms
Cohort Studies
Female
Humans
jenkins-FCD Prod-331 a335b1a6d1e9c32173c9534e6f6ff51494143916