- Despite having no delay in presentation, black women with stage 1 breast cancer (BCa) still have longer times to first treatment, surgery, and other therapies than whites in a large US cohort.
- Having private insurance diminishes some of this effect, but racial disparities persist.
Why this matters
- Racial disparities in time to care, although not oncologically significant, suggest institutional hurdles beyond private health insurance that must be addressed.
- Retrospective cohort of 546,351 patients with stage 1 BCa in the US National Cancer Data Base: 90.6% were white, 9.4% were black.
- Funding: None disclosed.
- Black women (vs white), regardless of insurance type, had significantly (P<.001 longer times to:>
- first treatment (35.5 vs 28.1 days),
- surgery (36.6 vs 28.8 days; Δ, 7.8 days),
- chemotherapy (88.1 vs 75.4 days),
- radiation (131.3 vs 99.1 days), and
- endocrine therapy (152.1 vs 126.5 days).
- In the subgroup with private insurance:
- Time to surgery for blacks (vs whites) decreased by 1.2 days (from 7.8 to 6.6 days=1.2 days), but still remained significant, as did all other times to treatment (all P<.001>
- Black women had worse OS (94.3% vs 95.9% in whites; P<.001>
- Retrospective, observational design.