Fedewa Stacey A, Edge Stephen B, Stewart Andrew K, Halpern Michael T, Marlow Nicole M, Ward Elizabeth M
Health Services Research, American Cancer Society, Atlanta, GA 30303, USA.
J Health Care Poor Underserved. 2011 Feb;22(1):128-41. doi: 10.1353/hpu.2011.0006.
Access to timely treatment may be one contributing factor to survival differences by race/ethnicity among breast cancer patients. In this study, we examined the relationship between race and treatment delay among breast cancer patients diagnosed between 2003 and 2006 with Stage I-III breast cancer from the National Cancer Database (n=250,007). We evaluated factors associated with receipt of initial treatment more than 30, 60, and 90 days after biopsy using multivariable log binomial models to estimate risk ratios (RR) and 95% confidence intervals (CI). The average time to treatment was 34.30 days (±31.77). Independent of health insurance, stage at diagnosis, and age, Black and Hispanic patients had higher risks of 30, 60, and 90-day treatment delay compared with White patients. Further studies are needed to define the role of structural, health system, physician, clinical and patient factors in treatment delay among Black and Hispanic women and appropriate interventions.
能否获得及时治疗可能是乳腺癌患者种族/族裔生存差异的一个促成因素。在本研究中,我们调查了2003年至2006年间从国家癌症数据库中确诊为I-III期乳腺癌的患者(n=250,007)的种族与治疗延迟之间的关系。我们使用多变量对数二项模型评估活检后30天、60天和90天以上接受初始治疗相关的因素,以估计风险比(RR)和95%置信区间(CI)。平均治疗时间为34.30天(±31.77)。与白人患者相比,在不考虑健康保险、诊断分期和年龄的情况下,黑人和西班牙裔患者出现30天、60天和90天治疗延迟的风险更高。需要进一步研究来确定结构、卫生系统、医生、临床和患者因素在黑人和西班牙裔女性治疗延迟中的作用以及适当的干预措施。