title: Black Medicaid beneficiaries experience breast cancer treatment delays more frequently than whites.
abstract: OBJECTIVE
  Delays in treatment initiation may contribute to the poorer breast cancer survival among Black women compared with Whites. Lower socioeconomic status and lack of access to care are other reasons for the observed disparities. We, therefore, examined racial differences in treatment delays for early breast cancer in a similarly insured population of Medicaid beneficiaries.
  
  
  METHODS
  A retrospective cohort study using linked New Jersey Cancer Registry and Medicaid Research files using logistic regression models.
  
  
  METHODS
  237 Black and 485 White women aged 20-64 years diagnosed with early breast cancer between 1997 and 2001.
  
  
  METHODS
  Delays in treatment initiation.
  
  
  RESULTS
  Blacks experience adjuvant chemotherapy delays more often than Whites. Black women had two-fold odds (95% confidence interval, 1.04, 4.38) of > or = 3 months delay in adjuvant chemotherapy than Whites. Blacks were also more likely to experience radiation treatment delays but this finding was not statistically significant (odds ratio 1.72, 95% CI .79, 3.77). No racial differences were observed for surgical and hormonal treatment delays.
  
  
  CONCLUSIONS
  Blacks experienced delays in initiating adjuvant chemotherapy more frequently than Whites. These differences were observed even in a population with similar socioeconomic status and insurance access, suggesting that cultural and psychosocial factors may contribute to the observed differences.
authors.affiliation: Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Dallas, TX 75390-9128, USA. a.balasubramanian@uth.tmc.edu
authors.forename: Bijal A
authors.initials: BA
authors.lastname: Balasubramanian
authors.forename: Kitaw
authors.initials: K
authors.lastname: Demissie
authors.forename: Benjamin F
authors.initials: BF
authors.lastname: Crabtree
authors.forename: Pamela A Ohman
authors.initials: PA
authors.lastname: Strickland
authors.forename: Karen
authors.initials: K
authors.lastname: Pawlish
authors.forename: George G
authors.initials: GG
authors.lastname: Rhoads
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000208:ethnology* / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D016001:Confidence Intervals; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008408:Mastectomy; D008484:Medicaid / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013997:Time Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult