title: Are disparities of waiting times for breast cancer care related to socio-economic factors? A regional population-based study (France).
abstract: The increasing number of breast cancer cases may induce longer waiting times (WT), which can be a source of anxiety for patients and may play a role in survival. The aim of this study was to examine the factors, in particular socio-economic factors, related to treatment delays. Using French Cancer Registry databases and self-administered questionnaires, we included 1,152 women with invasive non-metastatic breast cancer diagnosed in 2007. Poisson regression analysis was used to identify WTs' influencing factors. For 973 women who had a malignant tissue sampling, the median of overall WT between the first imaging procedure and the first treatment was 44 days (9 days for pathological diagnostic WT and 31 days for treatment WT). The medical factors mostly explained inequalities in WTs. Socio-economic and behavioral factors had a limited impact on WTs except for social support which appeared to be a key point. Better identifying the factors associated with increase in WTs will make it possible to develop further interventional or prospective studies to confirm their causal role in delay and at last reduce disparities in breast cancer management.
authors.affiliation: Registre Des Cancers De Loire-Atlantique-Vendée, Nantes, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Ayrault-Piault
authors.affiliation: Registre Des Cancers Du Tarn, Institut Claudius Regaud, IUCT-O, LEASP-UMR 1027 Inserm-Université De Toulouse, Toulouse, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Grosclaude
authors.affiliation: Registre Des Cancers Du Tarn, Institut Claudius Regaud, IUCT-O, LEASP-UMR 1027 Inserm-Université De Toulouse, Toulouse, France.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Daubisse-Marliac
authors.affiliation: Département D'Information Médicale, Cellule d'Identito-Vigilance, CHU Toulouse, Toulouse, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Pascal
authors.affiliation: Service D'Information Médicale, CHU Nantes, Nantes, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Leux
authors.affiliation: Registre Des Tumeurs Du Doubs Et Du Territoire De Belfort, CHRU Besançon, EA3181, Université De Franche-Comté, Besançon, France.
authors.forename: Evelyne
authors.initials: E
authors.lastname: Fournier
authors.affiliation: Registre Des Cancers De Loire-Atlantique-Vendée, Nantes, France.
authors.forename: Anne-Delphine
authors.initials: AD
authors.lastname: Tagri
authors.affiliation: Registre Des Cancers De Loire-Atlantique-Vendée, Nantes, France.
authors.forename: Magali
authors.initials: M
authors.lastname: Métais
authors.affiliation: Laboratoire « Éducations Et Pratiques De Santé » EA3412, Université Paris 13-Sorbonne Paris Cité, Bobigny, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Lombrail
authors.affiliation: Registre Des Tumeurs Du Doubs Et Du Territoire De Belfort, CHRU Besançon, EA3181, Université De Franche-Comté, Besançon, France.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Woronoff
authors.affiliation: Registre Des Cancers De Loire-Atlantique-Vendée, Nantes, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Molinié
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005602:France / Q000453:epidemiology; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012041:Regional Medical Programs / Q000706:statistics & numerical data; D012042:Registries; D012044:Regression Analysis; D057566:Self Report; D012959:Socioeconomic Factors; D061665:Time-to-Treatment / Q000706:statistics & numerical data*
keywords: breast cancer; cancer registry; population-based study; socio-economic factors; waiting time