Table 3.
Crude and multivariable logistic regression analyses of factors associated with refusing to undergo surgery as recommend among US women 40 or above between 2010 and 2017
| Variable | Crude Odds Ratio of refusing the recommended surgery (95% Confidence Interval) |
Adjusted Odds Ratio of refusing the recommended surgery (95% Confidence Interval) |
|---|---|---|
| Race and ethnicity | ||
| Non-Hispanic White | 1.00 (reference) | 1.00 (reference) |
| Non-Hispanic Black | 1.87 (1.63–2.15)*** | 2.12 (1.82–2.47)*** |
| Hispanic (All races) | 0.93 (0.78–1.11)ns | 0.97 (0.81–1.17)ns |
| Other | 1.18 (0.99–1.397)ns | 1.18 (0.99–1.42)ns |
| Subtypes | ||
| Luminal A | 1.00 (reference) | 1.00 (reference) |
| Luminal B | 1.27 (1.08–1.48)** | 1.93 (1.62–2.28)*** |
| HER2 enriched | 1.11 (0.86–1.43)ns | 1.64 (1.25–2.16)*** |
| Triple negative | 0.94 0(.79–1.12)ns | 1.36 (1.12–1.66)** |
| Age at diagnosis | ||
| 40–49 | 1.00 (reference) | 1.00 (reference) |
| 50–59 | 1.14 (0.92–1.4)ns | 1.15 (0.93–1.43)ns |
| 60–69 | 1.05 (0.85–1.29)ns | 1.04 (0.84–1.29)ns |
| 70–79 | 1.53 (1.24–1.89)*** | 0.97 (.77–1.21)ns |
| 80+ | 9.74 (8.10–11.71)*** | 3.06 (2.48–3.78)*** |
| Tumor grade | ||
| Grade I; well differentiated | 1.00 (reference) | 1.00 (reference) |
| Grade II; moderately differentiated | 1.37 (1.20–1.56)*** | 1.31 (1.14–1.49)*** |
| Grade III; poorly differentiated | 1.11 (0.954–1.282)ns | 1.11 (0.94–1.32)ns |
| Tumor site | ||
| Nipple | 1.00 (reference) | 1.00 (reference) |
| Central portion of the breast | 1.12 (0.55–2.30)ns | 1.73 (0.83–3.60)ns |
| Upper-inner quadrant of the breast | 0.65 (0.32–1.33)ns | 1.85 (0.89–3.84)ns |
| Lower-inner quadrant of the breast | 0.59 (0.28–1.21)ns | 1.54 (0.73–3.25)ns |
| Upper-outer quadrant of the breast | 0.60 (0.30–1.22)ns | 1.78 (0.87–3.66)ns |
| Lower-outer quadrant of the breast | 0.59 (0.9–1.21)ns | 1.57 (0.75–3.28)ns |
| Axillary tail of the breast | 0.67 (0.24–1.86)ns | 1.75 (0.62–4.99)ns |
| Overlapping lesion of the breast | 0.75 (0.37–1.52)ns | 1.92 (0.93–3.96)ns |
| Tumor stage | ||
| Localized only | 1.00 (reference) | 1.00 (reference) |
| Regional, direct extension only | 6.91 (5.67–8.43)*** | 4.2 (3.39–5.21)*** |
| Regional, lymph nodes only | 0.90 (0.79–1.03)ns | 1.57 (1.37–1.81)*** |
| Regional, both direct extension and lymph nodes | 2.93 (2.41–3.57)*** | 4.02 (3.23–4.98)*** |
| Marital status | ||
| Married | 1.00 (reference) | 1.00 (reference) |
| Unmarried/Domestic partner | 0.35 (0.05–2.48)ns | 0.4 (0.05–2.84)ns |
| Divorced | 2.00 (1.68–2.37)*** | 1.69 (1.42–2.02)*** |
| Widowed | 4.97 (4.39–5.63)*** | 1.66 (1.43–1.93)*** |
| Separated | 3.31 (2.27–4.82)*** | 2.79 (1.88–4.15)*** |
| Never married | 2.44 (2.10–2.83)*** | 1.88 (1.61–2.19)*** |
| Year of diagnosis | ||
| 2010 | 1.00 (reference) | 1.00 (reference) |
| 2011 | 1.20 (0.93–1.56)ns | 1.26 (0.97–1.64)ns |
| 2012 | 1.44 (1.13–1.84)** | 1.51 (1.18–1.93)** |
| 2013 | 1.35 (1.058–1.731)* | 1.45 (1.13–1.87)** |
| 2014 | 1.45 (1.134–1.84))** | 1.61 (1.25–2.06)*** |
| 2015 | 1.87 (1.489–2.357)*** | 2.09 (1.66–2.65)*** |
| 2016 | 1.95 (1.55–2.44)*** | 2.26 (1.79–2.85)*** |
| 2017 | 2.00 (1.60–2.51)*** | 2.25 (1.79–2.84)*** |
| Median income | ||
| < $35,000 | 1.00 (reference) | 1.00 (reference) |
| $35,000–$44,999 | 1.05 (0.62–1.76)ns | 1.08 (0.632–1.85)ns |
| $45,000–$54,999 | 1.27 (0.774–2.079)ns | 1.52 (0.89–2.57))ns |
| $55,000–$64,999 | 1.03 (0.63–1.676)ns | 1.20 (0.71–2.06)ns |
| $65,000–$74,999 | 1.22 (0.746–1.984)ns | 1.48 (0.86–2.54)ns |
| > $75,000 | 1.33 (0.82–2.16)ns | 1.85 (1.08–3.16)* |
| Urban–Rural | ||
| Counties in metropolitan areas greater than 1 million | 1.00 (reference) | 1.00 (reference) |
| Counties in metropolitan areas of 250 k to 1 million | 1.04 (0.918–1.181)ns | 1.17 (1.02–1.337)* |
| Counties in metropolitan areas less than 250 k | 0.83 (0.662–1.031)ns | 0.91 (.712–1.159)ns |
| Non-metropolitan counties adjacent to a metropolitan area | 0.81 0(.638–1.035)ns | 0.96 (.728–1.265)ns |
| Non-metropolitan counties non-adjacent to a metropolitan area | 0.91 (0.70–1.20)ns | 1.02 (0.75–1.40)ns |
| Radiation therapy | ||
| No | 1.00 (reference) | 1.00 (reference) |
| Yes | 0.01 (0.01–0.02)*** | 0.02 (0.01–0.02)*** |
| Chemotherapy | ||
| No | 1.00 (reference) | 1.00 (reference) |
| Yes | 0.14 (0.12–0.17)*** | 0.17 (0.13–0.20)*** |
Values are n (% of column total). For the p-value, ns indicates not significant, *p < 0.05, **p < 0.01, ***p < 0.001
HER2 Human epidermal growth factor receptor 2