佐治亚州乳腺癌女性患者的出行负担与手术及时性之间的关联
Association between travel burden and surgical timeliness for women with breast cancer in Georgia.
作者信息
Rademacher Nicole, McLeod M Chandler, Williams Courtney P, Awan Sofia, McElroy Katherine E, Saini Geetanjali, Gogineni Keerthi, Luningham Justin M, Aneja Ritu, Gutnik Lily A
机构信息
University of Alabama at Birmingham, Department of Surgery, Birmingham, AL, USA.
University of Alabama at Birmingham, Department of Surgery, Birmingham, AL, USA; University of Alabama at Birmingham, Division of Transplantation, USA.
出版信息
Am J Surg. 2025 Sep;247:116484. doi: 10.1016/j.amjsurg.2025.116484. Epub 2025 Jun 16.
INTRODUCTION
This study evaluates associations between patient distance traveled to surgical care and receipt of timely breast cancer surgery in Georgia.
METHODS
This retrospective cohort study included electronic health record data from women diagnosed with stage I-III breast cancer from 2004 to 2020 who received upfront surgery. Race was self-reported. Distance from patient home address to surgical treatment facility was measured as crow-fly distance. Multivariable logistic regression models estimated associations between time to surgery, race, and distance.
RESULTS
Of 18,240 patients (White = 61 % and Black = 39 %) with a median distance to surgery of 11.4 miles (IQR: 5.9, 19.6), Black patients had approximately half the odds of receiving surgery within the recommended 60 days of diagnosis (OR: 0.52, 95 % CI: 0.47-0.56). Distance traveled was not associated with time to surgery.
CONCLUSION
Understanding mechanisms driving surgical care delays and their effects on breast cancer outcomes is critical to reducing inequities in breast cancer care.
引言
本研究评估了佐治亚州患者前往接受手术治疗的距离与及时接受乳腺癌手术之间的关联。
方法
这项回顾性队列研究纳入了2004年至2020年期间被诊断为I - III期乳腺癌且接受了前期手术的女性的电子健康记录数据。种族由患者自我报告。从患者家庭住址到手术治疗机构的距离按直线距离测量。多变量逻辑回归模型估计了手术时间、种族和距离之间的关联。
结果
在18240名患者中（白人占61%，黑人占39%），手术的中位距离为11.4英里（四分位间距：5.9，19.6），黑人患者在诊断后60天内接受手术的几率约为白人患者的一半（比值比：0.52，95%置信区间：0.47 - 0.56）。出行距离与手术时间无关。
结论
了解导致手术治疗延迟的机制及其对乳腺癌治疗结果的影响对于减少乳腺癌治疗中的不平等现象至关重要。
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