Study Highlights Racial and Geographic Disparities in Timely Breast Cancer Treatment

Both race and geographic region were significantly associated with delayed breast cancer treatment. study was announced in cancersuggesting that both high-risk patients and high-risk areas should be prioritized by clinical and policy strategies to improve care disparity.

delay of breast cancer Previous studies have found that diagnosis and treatment are associated with worse disease-specific and overall survival, and black patients are disproportionately at risk for delayed breast cancer treatment.

In this large population-based cohort study, variability in breast cancer diagnosis-to-treatment time between 2004 and 2017 in North Carolina was correlated with two distinct patient characteristics: race and patient geographic region. was investigated based on The analysis showed that black patients were more likely to experience treatment delays, as were patients of a racial or ethnic background who lived in a particular area.

A total of 32,626 patients participated in the study, of whom 6,190 (19%) were black. These patients were younger than the rest of the cohort (64 vs. 68), were more likely to receive chemotherapy prior to other treatments (14.8% vs. 7.6%), and had hormone receptor-negative tumors. likely (29.3%). vs 15.6%) compared to the non-Black cohort.

Black patients were more likely than non-Black patients to have Medicaid insurance (46.7% vs. 14.9%) and were more likely to live within 5 miles of the place of treatment (30.6% vs. 25.2%). They were also more likely to live in census districts in the highest category of social deprivation compared to non-black patients in the cohort (52% vs. 18.6%).

Delays in treatment beyond 60 days, a threshold consistently associated with worse outcome, were more common in black patients, 15% of whom experienced such delays. In the non-black cohort, his 8% of patients faced her 60 days or longer delay. The median duration of treatment for a black patient was 30 days compared to her 26 days for non-black patients.

For both black and non-black patients, the likelihood of delayed treatment varied by region of the state. Patients in regions with the highest risk of delay were twice as likely to experience delay as those in regions with the lowest risk of delay. The size of the racial disparity also varied by region, with no significant difference found in one region (only 2.7% of his patients in this region were black), but the most pronounced disparity was his 9.4%. was.

“Importantly, regional differences in timeliness were not explained by clinical or sociodemographic characteristics. [of] patient,” the author wrote. “The substantial geographic variability we observed in the delivery of timely and equitable breast cancer care suggests that these results are modifiable and serve as clinical and policy priorities for intervention in high-risk areas. suggesting that it is a matter

Overall, the findings highlight multiple factors that may influence disparities in the timeliness of breast cancer care. Identifying areas where delays are common and investigating different aspects of care delivery in these areas will be important areas for future research, the authors write. Further research on delays in

“On average, about one in seven black women who participated in our study experienced long delays, but this risk varied depending on where the women lived within the state. was not explained by the patient’s distance from the cancer treatment facility, the specific stage of cancer or type of treatment, or the insurance they had,” said study author Catherine E. Reeder Hayes, MD. , MBA, MS, UNC Lineberger Comprehensive Cancer Center said: statement“These findings suggest that the structure of the local healthcare system, rather than the patient’s own characteristics, may better explain why some patients experience treatment delays and other adverse cancer outcomes.” suggests that there is

reference

Reeder-Hayes KE, Jackson BE, Baggett CD Multi-race, geography, and risk of delay in breast cancer treatment: population-based study 2004–2015. cancer. Published online January 23, 2023. doi:10.1002/cncr.34573