Racial differences in diagnosis, treatment, and clinical delays in a population-based study of patients with newly diagnosed breast carcinoma

Authors

  • Karin Gwyn M.D., M.P.H.,

    Corresponding author
    1. Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    2. Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    • Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Unit 424, Houston, TX 77030
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    • Fax: (713) 794-4385

  • Melissa L. Bondy Ph.D.,

    1. Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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  • Deborah S. Cohen M.S.,

    1. Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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  • Mary Jo Lund M.S.P.H., M.T.(ASCP),

    1. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
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  • Jonathan M. Liff Ph.D.,

    1. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
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  • Elaine W. Flagg Ph.D.,

    1. Surveillance and Epidemiology Branch, Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Louise A. Brinton Ph.D.,

    1. Hormonal and Reproductive Epidemiology Branch, National Cancer Institute, Bethesda, Maryland
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  • J. William Eley M.D., M.P.H.,

    1. Winship Cancer Institute, Emory University, Atlanta, Georgia
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  • Ralph J. Coates Ph.D.

    1. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • This article is a U.S. Government work and, as such, is in the public domain in the United States of America.

  • The views expressed herein do not necessarily reflect the views of the Centers for Disease Control and Prevention or the U.S. Government.

Abstract

BACKGROUND

Few studies have addressed the issue of whether delays in the interval between medical consultation and the diagnosis and treatment of breast carcinoma are greater for African American women than for white women. The authors examined differences with respect to these delays and analyzed the factors that may have contributed to such differences among women ages 20–54 years who had invasive breast carcinoma diagnosed between 1990 and 1992 and who lived in Atlanta, Georgia.

METHODS

A total of 251 African American women and 580 white women were interviewed and had their medical records reviewed. The authors estimated racial differences in delay times and used polytomous logistic regression to determine the contributions of various factors (socioeconomic and other) to these differences.

RESULTS

Although most women in both groups were treated within 3 months of initial consultation, 22.4% of African American women and 14.3% of white women had clinical delays of > 3 months. Compared with white women, African American women were more likely to experience delays in diagnosis and treatment. Access to care (as represented by method of detection and insurance status) and poverty index partially accounted for these differences in delay time; however, racial differences in terms of delayed treatment and diagnosis remained even after adjustment for contributing factors.

CONCLUSIONS

The findings of the current study suggest that among women ages 20–54 years who have breast carcinoma, potentially clinically significant differences in terms of delayed diagnosis and treatment exist between African American women and white women. Improvements in access to care and in socioeconomic circumstances may address these differences to some degree, but additional research is needed to identify other contributing factors. Cancer 2004. Published 2004 American Cancer Society.

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