{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:35:54Z","timestamp":1781242554735,"version":"3.54.1"},"reference-count":83,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"30","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["J Clin Oncol"],"published-print":{"date-parts":[[2025,10,20]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE<\/jats:title>\n            <jats:p>This study evaluated racial and ethnic disparities along the treatment cascade for Medicare fee-for-service patients with metastatic breast, colorectal, lung, and prostate cancers and disparities in overall survival by treatment receipt and quantified factors contributing to these disparities.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>Medicare fee-for-service beneficiaries with newly diagnosed metastatic hormone receptor\u2013positive\/human epidermal growth factor receptor 2\u2013negative breast, colorectal, non\u2013small cell lung, and prostate cancers from the SEER-Medicare-linked database (2016-2020) were studied. We used multivariable logistic regression to evaluate disparities along the treatment cascade, multivariable Cox regressions to evaluate disparities in overall survival by treatment receipt, and Oaxaca-Blinder decomposition to quantify the contribution of factors related to disparities.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>\n              Of 18,652 White, 1,898 Black, and 1,465 Hispanic beneficiaries, within 2 months of diagnosis, 78% of patients were alive and 87% saw a medical oncologist\u2014without consistent disparities. There were disparities in receiving any systemic therapy: breast (59% of Black patients received systemic therapy, 60% Hispanic, 68% White,\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              = .021), colorectal (23% Black, 31% Hispanic, 34% White,\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt; .001), lung (26% Black, 37% Hispanic, 39% White,\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt; .001), and prostate (56% Black, 76% Hispanic, 77% White,\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt; .001) cancers. For every cancer, &lt;35% of patients received guideline-directed systemic therapy. After restricting to patients who received any systemic therapy within 2 months of diagnosis, overall survival disparities were no longer significant. Across all malignancies, low-income subsidy status\u2014of which 87.6% was dual-eligible\u2014contributed most to explaining disparities in treatment (20%-45% of the disparity).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>Care delivery and policy interventions intended to narrow racial and ethnic overall survival disparities in Medicare patients with metastatic cancer should target disparities in not receiving first-line systemic therapy and address the unique needs of beneficiaries with low-income subsidy status or dual eligibility.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1200\/jco-24-02440","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:59:13Z","timestamp":1756324753000},"page":"3254-3265","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":4,"title":["Racial and Ethnic Disparities Along the 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