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System delay in breast cancer in whites and blacks
L S Caplan1, K J Helzlsouer, S Shapiro
1Department of Preventive Medicine, School of Medicine, State University of New York at Stony Brook, USA.
American Journal of Epidemiology
|October 15, 1995
Summary
System delay between medical consultation and breast cancer diagnosis did not significantly differ between Black and White women. Interventions should target younger women without a palpable lump to reduce diagnostic delays.
Area of Science:
- Oncology
- Public Health
- Health Disparities
Background:
- Noted survival differences exist between Black and White women diagnosed with breast cancer.
- Prolonged system delay (time from consultation to diagnosis) may contribute to advanced disease stage and survival disparities.
Purpose of the Study:
- To determine if system delay differs between Black and White breast cancer patients.
- To identify predictors of system delay in both racial groups.
Main Methods:
- Analysis of 996 female breast cancer patients from the National Cancer Institute's Black/White Cancer Survival Study (1985-1986).
- Examined median system delay and its association with race, clinical presentation, and patient demographics.
Main Results:
- Median system delay was slightly longer for Black women (2.7 weeks) than White women (2.1 weeks), but not statistically significant.
- Palpable lump at diagnosis reduced delay; public clinic use increased delay for Black women.
- Older women experienced less delay, particularly White women.
Conclusions:
- Systemic delays in diagnosis are unlikely to explain survival differences between Black and White women with breast cancer.
- Significant delays (≥3 months) were observed in many women.
- Interventions should focus on younger women presenting without a palpable lump to reduce diagnostic delays.
