Black, hispanic women with breast cancer face treatment delays

At a time when access to prompt treatment might affect survival, a large new study finds that African-American and Hispanic women newly diagnosed with breast cancer often face delays in care of more than a month.

In the study appearing in the February issue of the Journal of Health Care for the Poor and Underserved, researchers evaluated data from the National Cancer Database to examine the link between race and treatment delay among more than 250,000 women who were diagnosed with stage I to stage III breast cancer between 2003 and 2006.

Researchers found that 62.4 percent of African-American women and 59.3 percent of Hispanic women received a diagnosis of stage II or stage III breast cancer compared with 48.9 percent of white women, and past research has linked diagnosis at advanced stages to lower survival rates. Delays in treatment were apparent in the new study, as African-American and Hispanic women had higher risks of 30-, 60- and 90-day delays compared to white women.

“I was surprised at how strong the associations between race and ethnicity and the risk of 60- and 90-day delays were,” said lead author Stacey Fedewa, an epidemiologist at the American Cancer Society in Atlanta.

For example, the risk of a 60-day treatment delay was 76 percent higher among African-American patients with private insurance than that of white patients with comparable insurance. Hispanics with private insurance had a 57 percent higher risk of a 60-day delay compared with whites.

Peter Ravdin, M.D., director of the Breast Health Clinic at the University of Texas Health Science Center San Antonio, said that although the “diagnosis of breast cancer is not an absolute day-by-day emergency,” clinicians try to see that patients start therapy as quickly as possible.

“Certainly sometimes, unfortunately, access to the health care system is an issue,” Ravdin said. “However, most women want to get a positive course of action started as soon as it is safe, and most health care teams try to see that such therapy starts as soon as all the information needed for treatment planning is available.”

The study’s more encouraging findings were that a majority — 60 percent — of the patients did receive prompt treatment after diagnosis — with an average time to treatment of 34 days.

“It’s a positive sign that breast cancer patients are being treated in a timely manner,” said Fedewa. “However, more work needs to be done to determine and alleviate the patient and structural barriers preventing select subsets of breast cancer patients, particularly Hispanic and black patients, from receiving timely treatment.”