Date of Conferral

2021

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Nancy Rea

Abstract

Early-stage breast cancer can be highly curable when properly treated using national standards of care. However, disparities in treatment, including radiation therapy after lumpectomy, may result in disproportional mortality rates in African American women. The purpose of this study was to add to the body of research to help determine the reasons for an underutilization of radiation therapy among African American women and whether the disparity has continued by analyzing recent patient data. Anderson’s behavioral model was used to frame the study and help determine the associations between the predisposing and enabling independent variables of race, age, health insurance status, and residential urbanicity and the dependent variable of radiation therapy use. This retrospective quantitative study used data from the National Cancer Institute Surveillance, Epidemiology, and End Results Program of women in Georgia diagnosed with early-stage breast cancer between 2012–2016. Logistic regression analysis of case files indicated that there were no statistically significant racial association, (p = .517), after controlling for age, in receiving radiation therapy after lumpectomy in Georgia. Furthermore, logistic regression analysis indicated that residential urbanicity and health insurance status did not significantly predict radiation therapy usage among women with early-stage breast cancer after controlling for race and age. The findings were not significant and did not show an increase in use of critical radiation treatment by African Americans. These results justify an expansion of interventions by cancer facilities to increase breast cancer treatment with radiation therapy. Appropriate treatment may improve survival rates of African Americans and those living in rural areas, which would lead to positive social change.

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