55 Fruit St, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 165 Cambridge St, Suite 403, Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
165 Cambridge St, Suite 403, Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 55 N Lake Ave, UMass Chan Medical School, Worcester, MA, USA.
Am J Surg. 2023 Oct;226(4):432-437. doi: 10.1016/j.amjsurg.2023.05.024. Epub 2023 May 25.
BACKGROUND: We evaluated whether time to surgery by race can be a health equity metric of surgical access. METHODS: An observational analysis was performed using the National Cancer Database from 2010 to 2019. Inclusion criteria were women with stage I-III breast cancer. We excluded women with multiple cancers and whose diagnosis was made at a different hospital. The primary outcome variable was surgery within 90 days of diagnosis. RESULTS: A total of 886,840 patients were analyzed, with 76.8% White and 11.7% Black patients. 11.9% of patients experienced delayed surgery, which was significantly more common in Black patients than White patients. On adjusted analysis, Black patients were still significantly less likely to receive surgery within 90 days when compared to White patients (OR 0.61, 95% CI 0.58-0.63). CONCLUSION: The delay in surgery experienced by Black patients highlights the contribution of system factors in cancer inequity and should be a focus for targeted interventions.
背景：我们评估了按种族划分的手术时间是否可以作为衡量手术机会公平性的一个健康公平指标。 方法：本观察性分析使用了 2010 年至 2019 年国家癌症数据库的数据。纳入标准为患有 I-III 期乳腺癌的女性。我们排除了患有多种癌症且诊断在不同医院进行的女性。主要结局变量为诊断后 90 天内进行手术。 结果：共分析了 886840 名患者，其中 76.8%为白人，11.7%为黑人患者。11.9%的患者经历了延迟手术，黑人患者的延迟手术明显比白人患者更为常见。在调整分析中，与白人患者相比，黑人患者在 90 天内接受手术的可能性仍然显著降低（OR 0.61，95%CI 0.58-0.63）。 结论：黑人患者手术延迟凸显了系统因素在癌症不公平中的作用，应成为有针对性干预措施的重点。
Am J Surg. 2023-10
Ann Surg Oncol. 2015-9
J Womens Health (Larchmt). 2015-3
JNCI Cancer Spectr. 2022-2
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