title: Evaluation of therapeutic care delay among Latina- and European-American cervical cancer survivors.
abstract: OBJECTIVE
  Cervical cancer (CCA) ranks among the deadliest of cancers. Globally CCA claims 275,000 lives yearly. Severe delays, in cancer diagnostic or therapeutic care, that approach ≥ 60 days negatively affect survival and survivorship outcomes. This study investigated socioeconomic and healthcare system factors influencing therapeutic care delays among cervical cancer survivors (CCS).
  
  
  METHODS
  291 CCS (132 European-, 50 English-proficient (EP) Latina- and 109 limited English-proficient (LEP) Latina-Americans) were recruited from cancer registries. CCS retrospectively noted the days of delay in obtaining therapeutic care and reasons for delays.
  
  
  RESULTS
  CCS who were LEP Latina-Americans, had lower income and education reported severe therapeutic delays (≥ 60 days). LEP Latina-Americans experienced delays due to financial issues, doctor's delay, and healthcare system issues (p < 0.001). Doctor and healthcare system delays significantly influenced therapeutic care delay in the logistic regression model.
  
  
  CONCLUSIONS
  Healthcare system delays are primary contributors to ethnic differences in access to appropriately-timed care observed in this study. Healthcare professionals need to develop a fuller appreciation of the multilevel factors that contribute to healthcare barriers to better inform effective interventions to increase access to life saving care.
authors.affiliation: Center of Community Alliance for Research and Education, Department of Population Sciences, City of Hope National Medical Center, Duarte, CA 91010-3000, USA. kashing@coh.org
authors.forename: Kimlin
authors.initials: K
authors.lastname: Ashing-Giwa
authors.forename: Monica
authors.initials: M
authors.lastname: Rosales
mesh_terms: D000368:Aged; D002140:California; D057210:Delayed Diagnosis; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D012959:Socioeconomic Factors; D017741:Survivors; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000208:ethnology* / Q000628:therapy*; D044465:White People