Delayed radiotherapy for breast cancer patients in integrated delivery systems.
OBJECTIVE
To identify factors associated with delayed radiotherapy (RT) in older women with early-stage breast cancer.


METHODS
We studied 541 women age >or=65 years diagnosed with early-stage breast cancer in 1990-1994 at 5 integrated healthcare delivery systems and treated with breast-conserving surgery and RT, but not chemotherapy. We examined whether demographic, tumor, or treatment characteristics were associated with RT delays of >8 weeks postsurgery using chi(2) tests and multivariable logistic regression.


RESULTS
Seventy-six women (14%) had delayed RT, with a median delay of 14 weeks. Even though they had insurance and access to care, nonwhite and Hispanic women were much more likely than white women to have delayed RT (odds ratio = 3.3; 95% confidence interval = 1.7, 10) in multivariable analyses that controlled for demographic and clinical variables.


CONCLUSIONS
Timely RT should be facilitated through physician and patient education, navigation, and notification programs to improve quality of care. Queues for RT appointments should be evaluated on an ongoing basis to ensure adequate access. Future research should examine modifiable barriers to RT timeliness and whether delays impact long-term outcomes.
Gold
Heather Taffet
HT
Department of Public Health, Weill Cornell Medical College, New York, NY 10065-6304, USA. heg2001@med.cornell.edu
Thwin
Soe Soe
SS
Buist
Diana S M
DS
Field
Terry S
TS
Wei
Feifei
F
Yood
Marianne Ulcickas
MU
Lash
Timothy L
TL
Quinn
Virginia P
VP
Geiger
Ann M
AM
Silliman
Rebecca A
RA
D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D019033:Delivery of Health Care, Integrated; D005260:Female; D006801:Humans; D015999:Multivariate Analysis; D044469:Racial Groups; D013997:Time Factors; D014481:United States