Black women may be less likely to receive timely treatment for breast cancer

New research suggests that Black women experience longer waits for treatment initiation than white women after a breast cancer diagnosis, and their duration of treatment is prolonged. The findings are published early online in Cancer, a peer-reviewed journal of the American Cancer Society (ACS).

Previous research has shown that Black women face a higher risk of dying from breast cancer than white women despite similar rates of breast cancer occurrence, and this disparity is especially high among younger women. A team led by Melissa A. Troester, PhD, of the University of North Carolina at Chapel Hill (UNC) and UNC Lineberger Comprehensive Cancer Center evaluated whether two aspects of care--time to treatment and duration of treatment--may be contributing factors.

The investigators' analysis included 2,841 participants (roughly equal numbers of Black and white women) with stage I-III breast cancer in the Carolina Breast Cancer Study, a population-based study of women with invasive breast cancer.

The overall median time to treatment initiation was 34 days. More Black women experienced a delayed time to treatment (13.4 percent versus 7.9 percent) and a prolonged duration of treatment (29.9 percent versus 21.1 percent) compared with white women.

Thirty-two percent of young Black women were in the highest quartile of treatment duration, compared with 22.3 percent of younger white women; similarly, 27.9 percent of older Black women experienced prolonged treatment duration compared with 19.9 percent of older white women.

Also, among women with high socioeconomic status, 11.7 percent of Black women experienced delays in initiating treatment compared with 6.7 percent of white women.

"Even among women with low socioeconomic status, we still saw fewer delays among white women, underscoring the disparate experience of Black women, who appear to experience unique barriers," said lead author Marc Emerson, PhD.

"It is important to recognize that the causes of delay are complex and reflect both individual barriers and system level factors," Dr. Troester added. The study identified a number of specific barriers, including financial and transportation issues.

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"Breast cancer treatment delays by socioeconomic and health care access latent classes in Black and White women." Marc A. Emerson, Yvonne M. Golightly, Allison E. Aiello, Katherine E. Reeder-Hayes, Xianming Tan, Ugwuji Maduekwe, Marian Johnson- Thompson, Andrew F. Olshan, and Melissa A. Troester. Cancer; Published Online: September 21, 2020 (DOI: 10.1002/cncr.33121).

URL Upon Publication: http://doi.wiley.com/10.1002/cncr.33121

Author Contact: Bill Schaller, of the UNC Lineberger Communications office, at bill_schaller@med.unc.edu or +1 617-233-5507.

Cancer is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of Cancer is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. Cancer is published on behalf of the American Cancer Society by Wiley and can be accessed online.

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