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Delay in breast cancer treatment decreased survival in young women
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Adolescent and young adult women with breast cancer who experienced delays in treatment time experienced significantly shorter survival, according to results of a retrospective study.
The association between delayed treatment time and shorter survival was strongest among black women, those with no insurance or public insurance, and women with low socioeconomic status.
The researchers conducted the investigation to assess how treatment delay time, insurance type and socioeconomic status influenced 5-year outcomes in women with breast cancer. The researchers evaluated data from the California Cancer Registry database on 8,860 women aged 15 to 39 years who were diagnosed between 1997 and 2006.
Five-year survival among women who underwent surgery more than 6 weeks after diagnosis was 80% compared with 90% among women who underwent surgery less than 2 weeks after diagnosis (P=.005).
Significantly higher rates of black and Hispanic women experienced treatment delay times longer than 6 weeks compared with white women (15.3% vs. 8.1%). Researchers reported similar disparities when they compared patients based on insurance types (17.8% for no insurance or public insurance vs. 9.5% for private insurance) and socioeconomic status (17.5% for high socioeconomic status vs. 7.7% for low socioeconomic status).
Leigh Neumayer
Results from multivariate analysis indicated a longer time in treatment delay, late cancer stage, having public insurance or no insurance, and ER-negative status were significantly associated with shorter survival time.
“In this analysis, we have continued evidence of disparities in health care that lead to decreased survival, whether the disparity is a function of race, income or delays in receiving treatment,” Leigh Neumayer, MD, MS, of the University of Utah wrote in an accompanying editorial. “We should all work on eliminating these disparities in an effort to improve the health of our nation.”
For more information:
Neumayer L. JAMA Surg. 2013;doi:10.1001/jamasurg.2013.1691.
Smith EC. JAMA Surg. 2013;doi:10.1001/jamasurg.2013.1680.
Disclosure: The researchers report no relevant financial disclosures.