Faculty Collaboration Database

Breast cancer treatment delays by socioeconomic and health care access latent classes in Black and White women. Cancer 2020 Nov 15;126(22):4957-4966

Date

09/22/2020

Pubmed ID

32954493

Pubmed Central ID

PMC7789230

DOI

10.1002/cncr.33121

Scopus ID

2-s2.0-85091183216 (requires institutional sign-in at Scopus site)   95 Citations

Abstract

BACKGROUND: Breast cancer mortality is higher for Black and younger women. This study evaluated 2 possible contributors to disparities-time to treatment and treatment duration-by race and age.

METHODS: Among 2841 participants with stage I-III disease in the Carolina Breast Cancer Study, we identified groups of women with similar patterns of socioeconomic status (SES), access to care, and tumor characteristics using latent class analysis. We then evaluated latent classes in association with treatment delay (initiation >60 days after diagnosis) and treatment duration (in quartiles by treatment modality).

RESULTS: Thirty-two percent of younger Black women were in the highest quartile of treatment duration (versus 22% of younger White women). Black women experienced a higher frequency of delayed treatment (adjusted relative frequency difference [RFD], 5.5% [95% CI, 3.2%-7.8%]) and prolonged treatment duration (RFD, 8.8% [95% CI, 5.7%-12.0%]). Low SES was significantly associated with treatment delay among White women (RFD, 3.5% [95% CI, 1.1%-5.9%]), but treatment delay was high at all levels of SES in Black women (eg, 11.7% in high SES Black women compared with 10.6% and 6.7% among low and high SES White women, respectively). Neither SES nor access to care classes were significantly associated with delayed initiation among Black women, but both low SES and more barriers were associated with treatment duration across both groups.

CONCLUSIONS: Factors that influence treatment timeliness persist throughout the care continuum, with prolonged treatment duration being a sensitive indicator of differences by race, SES, and care barriers.

Author List

Emerson MA, Golightly YM, Aiello AE, Reeder-Hayes KE, Tan X, Maduekwe U, Johnson-Thompson M, Olshan AF, Troester MA

Author

Ugwuji N. Maduekwe MD Associate Dean, Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Breast Neoplasms
Delivery of Health Care
Female
Humans
Middle Aged
Neoplasm Staging
Social Class