title: Race and ethnicity are associated with delays in breast cancer treatment (2003-2006).
abstract: Access to timely treatment may be one contributing factor to survival differences by race/ethnicity among breast cancer patients. In this study, we examined the relationship between race and treatment delay among breast cancer patients diagnosed between 2003 and 2006 with Stage I-III breast cancer from the National Cancer Database (n=250,007). We evaluated factors associated with receipt of initial treatment more than 30, 60, and 90 days after biopsy using multivariable log binomial models to estimate risk ratios (RR) and 95% confidence intervals (CI). The average time to treatment was 34.30 days (±31.77). Independent of health insurance, stage at diagnosis, and age, Black and Hispanic patients had higher risks of 30, 60, and 90-day treatment delay compared with White patients. Further studies are needed to define the role of structural, health system, physician, clinical and patient factors in treatment delay among Black and Hispanic women and appropriate interventions.
authors.affiliation: Health Services Research, American Cancer Society, Atlanta, GA 30303, USA. Stacey.Fedewa@cancer.org
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Fedewa
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Edge
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Stewart
authors.forename: Michael T
authors.initials: MT
authors.lastname: Halpern
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Marlow
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Ward
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000208:ethnology* / Q000473:pathology / Q000628:therapy; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D012189:Retrospective Studies; D013997:Time Factors; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult