Abstract
Background: Multidisciplinary care (MDC) is an essential component of quality cancer care and includes the coordination of treatment provided by a team of 2+ multidisciplinary healthcare professionals. Although MDC is associated with improved health outcomes, it is still unclear if MDC is standard clinical practice among cancer patients or if disparities exist. This study assesses the multilevel (i.e., patient, provider, health system level, and neighborhood) factors associated with receipt of MDC. Methods: We used the Surveillance, Epidemiology and End Results (SEER)–Medicare data (2006-2016) to identify beneficiaries >65 years of age diagnosed with breast, colorectal, or lung cancer. We used multivariate analyses with random effects at the provider- and health system-level to assess the effect of multilevel factors on receipt of MDC. Results: From 2007 to 2015, receipt of MDC increased by 26.2%. Overall, 56.3% of patients received MDC within 2-months of a cancer diagnosis. Unadjusted analyses indicate that the odds of receiving MDC were 27% lower among Blacks compared to non-Hispanic Whites. Female, married, and dual Medicare-Medicaid coverage were significantly more likely to receive MDC (p<0.001). Among patients who received surgery, the odds of receipt of MDC were 40% higher among patients who saw a surgical oncologist compared to patients who saw a general surgeon. Patients whose surgery was performed at a hospital with Rural Primary Status were 53% less likely to receive MDC. Patients residing in more disadvantaged neighborhoods, based on the Area Deprivation Index, and in rural areas were also significantly less likely to receive MDC (p<0.01). Conclusion: Although receipt of MDC has steadily increased over the last decade, the prevalence of MDC among cancer patients remains strikingly low, especially among populations at-risk for health disparities. Future research should identify strategies that work synergistically at multiple levels to improve equitable access to and receipt of MDC for all cancer patients.
Citation Format: Janeth I. Sanchez, Michelle Doose, Veronica Chollette, Sallie J. Weaver. Multidisciplinary cancer care among breast, colorectal, and lung cancer patients: A SEER-Medicare analysis [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-003.