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Disparities in timely treatment among young women with breast cancer

  • Author Footnotes
    1 Urvish Jain and Bhav Jain contributed equally as co-first authors; and Drs. Chino and Dee contributed equally as co-corresponding authors.
    Urvish Jain
    Footnotes
    1 Urvish Jain and Bhav Jain contributed equally as co-first authors; and Drs. Chino and Dee contributed equally as co-corresponding authors.
    Affiliations
    University of Pittsburgh, Pittsburgh, PA, USA
    Search for articles by this author
  • Author Footnotes
    1 Urvish Jain and Bhav Jain contributed equally as co-first authors; and Drs. Chino and Dee contributed equally as co-corresponding authors.
    Bhav Jain
    Footnotes
    1 Urvish Jain and Bhav Jain contributed equally as co-first authors; and Drs. Chino and Dee contributed equally as co-corresponding authors.
    Affiliations
    Massachusetts Institute of Technology, Cambridge, MA, USA
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  • Oluwadamilola M. Fayanju
    Affiliations
    Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Rena Rowan Breast Center, Abramson Cancer Center, Penn Medicine, Philadelphia, PA, USA
    Search for articles by this author
  • Author Footnotes
    1 Urvish Jain and Bhav Jain contributed equally as co-first authors; and Drs. Chino and Dee contributed equally as co-corresponding authors.
    Fumiko Chino
    Correspondence
    Corresponding authors. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
    Footnotes
    1 Urvish Jain and Bhav Jain contributed equally as co-first authors; and Drs. Chino and Dee contributed equally as co-corresponding authors.
    Affiliations
    Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
    Search for articles by this author
  • Author Footnotes
    1 Urvish Jain and Bhav Jain contributed equally as co-first authors; and Drs. Chino and Dee contributed equally as co-corresponding authors.
    Edward Christopher Dee
    Correspondence
    Corresponding authors. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
    Footnotes
    1 Urvish Jain and Bhav Jain contributed equally as co-first authors; and Drs. Chino and Dee contributed equally as co-corresponding authors.
    Affiliations
    Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
    Search for articles by this author
  • Author Footnotes
    1 Urvish Jain and Bhav Jain contributed equally as co-first authors; and Drs. Chino and Dee contributed equally as co-corresponding authors.
Published:January 22, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.01.019

      Highlights

      • Black women experience treatment delays for non-metastatic breast cancer more frequently than white women.
      • Women in metro areas experience treatment delay more than women in rural areas.
      • Lower education and higher income were associated with treatment delay.
      • Improving access to timely treatment may lessen sociodemographic breast cancer disparities.

      Abstract

      Background

      Although evidence suggests worse breast cancer-specific survival associated with treatment delay beyond 90 days, little is known regarding the sociodemographic predictors of delays in cancer-directed surgery among young women with breast cancer. This is particularly notable, given that 5–10% of new diagnoses occur in younger women aged <40 years, commonly with more aggressive features than in older women.

      Methods

      We used the National Cancer Database (2004–2017) to assess sociodemographic disparities in delay of upfront surgery beyond 90 days among young women with non-metastatic breast cancer, using multivariable logistic regression and predictive marginal modeling.

      Results

      Black women experienced treatment delays more frequently than white women (aOR: 1.93 [95% CI: 1.76–2.11], p < 0.001). Adjusted rates of treatment delay were 4.91% [95% CI: 4.51%–5.30%] and 2.60% [95% CI: 2.47%–2.74%] for Black and white women, respectively, and 2.97% [95% CI: 2.83%–3.12%], 2.36% [95% CI: 2.03%–2.68%], and 1.18% [95% CI: 0.54%–1.81%] for women from metro, urban, and rural areas, respectively.

      Conclusion

      These results suggest that improving access to timely treatment may be leveraged as a means through which to lessen the breast cancer disparities experienced by Black women.

      Keywords

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