Variations in time to receiving first surgical treatment for breast cancer as a function of racial/ethnic background: a cohort study

Abstract

ObjectiveTo evaluate surgical treatment delay disparities by race/ethnic group in a group of breast cancer patients treated in the New York region.DesignCohort study.SettingTwo affiliated hospitals in the New York region.ParticipantsPatients admitted at two affiliated hospitals in the New York region for breast cancer treatment during 2007–2011.Main outcome measureTime to receiving first surgery for breast cancer, defined as the time in days between initial diagnosis (biopsy) and definitive surgical treatment (lumpectomy or mastectomy). Predicted time to first surgery by race group was also analysed using a multivariate linear regression model with adjustments made for several demographic and clinical factors.ResultsTotally, 3071 patients who were first treated with surgery were identified. Racial background was classified as White, African American or Asian/other. Overall median time to surgery was 28 days: 28 days in whites, and 34 and 29 days in African Americans and Asian/others, respectively (p = 0.032). Multivariate analyses showed that only African Americans, not Asian/others, had significantly increased surgical delay compared to whites (p = 0.019).ConclusionsThis study demonstrates significant racial differences in surgical delay in a group of breast cancer patients treated in the New York region. These differences may reflect tacit attitudes of medical providers or processes insensitive to patient educational needs. Additional studies may improve our understanding of this delay.

Predictive Factors for Diagnosis and Treatment Delay in Iranian Women with Breast Cancer

“…Unfortunately most cases are detected at more advanced stages and at lower ages in comparison with western countries (7,8). Some studies from Iran have attributed the problem to a lack of education and lack of a regular screening program and a delay in diagnosis and receiving medical treatment (9,10).…”

Survival Analysis of Women with Triple Negative Breast Cancer Using EMRLinked Cancer Registry Data in Florida

“…Black women have historically been less likely than Whites to be screened for breast cancer. Additionally, among Black women who undergo screening, delay in the timing of treatment initiation remains a consequence for increased recurrence and lower survival [21][22][23].…”

Symptom Experience, Management, and Outcomes According to Race and Social Determinants Including Genomics, Epigenomics, and Metabolomics (SEMOARS + GEM): an Explanatory Model for Breast Cancer Treatment Disparity

“…Social determinants of health associated with increased symptom experience and intensity are considered integral and specific to each patient. Race/ethnicity, age, income, education, zip code, allostatic load, comorbidity, and self-efficacy/belief in prescribed medication are social determinants of health that may be associated with increased symptoms resulting in dose reductions, chemotherapy holds, and early therapy cessation [68][69][70][71][72][73][74]. The following sections provide a review of evidence of these associations to date.…”