Socioeconomic status and delayed breast cancer care in Southeast Texas: a retrospective cohort study

Breast cancer is the most common cancer and the second leading cause of female cancer-related death in the US. Time to treatment initiation is often critical for improving cancer outcomes. Socioeconomic status (SES) is increasingly recognized as influential in cancer treatment efficacy.

This retrospective cohort study investigated associations between SES and delayed breast cancer treatment initiation across treatment modalities in Southeast Texas. Logistic regression models assessed the associations between delays and socioeconomic or clinical characteristics among 609 patients.

Regarding overall treatment, males, unmarried patients, younger patients, and Medicaid users experienced increased delay odds, while females, widows, and Medicare users experienced decreased odds. For chemotherapy, Tricare coverage was associated with excessive delay odds. Regarding surgical intervention, African Americans, unmarried patients, younger patients, and Medicaid users experienced increased delay odds, while Caucasians, older patients, and Medicare users experienced decreased odds. For radiation therapy, divorcees and those with Medicare and Medicaid eligibility experienced increased delay odds. Regarding hormone therapy, younger patients and Medicaid users experienced increased delay odds, while older patients and Medicare users experienced decreased odds. For immunotherapy, unmarried patients experienced increased delay odds, while being married conferred lower odds.

These results indicate that certain SES factors significantly predict treatment delays in breast cancer care.