Factors Mediating Racial/Ethnic Disparities in Delayed Treatment of Breast Cancer

Area of Science:

• Oncology
• Health Disparities Research
• Health Services Research

Background:

• Significant racial and ethnic disparities persist in breast cancer care, leading to unequal treatment delays and outcomes.
• Existing research highlights inequities in diagnosis and treatment access for minority populations.

Purpose of the Study:

• To quantify the specific mediators contributing to racial and ethnic disparities in breast cancer treatment delays.
• To identify factors that, if equalized, could reduce these disparities.

Main Methods:

• Retrospective analysis of 1,349,715 patients with stage I-III breast cancer from the National Cancer Database.
• Mediation analyses were employed to assess the role of patient characteristics in treatment delays across racial/ethnic groups.

Main Results:

• Black, Hispanic, and other non-white patients experienced 73%, 81%, and 24% increased odds of treatment delay, respectively, compared to white patients.
• Disparities in education, comorbidities, insurance, and facility type explained 15-19% of treatment delays among minority patients.
• Academic facility type emerged as a key mediator, potentially reducing disparities by 8-13%.

Conclusions:

• Racial and ethnic minority patients with breast cancer face longer treatment delays.
• Targeting mediators like education, insurance, and facility type can substantially decrease racial/ethnic disparities in delayed treatment.