ASPO Abstracts
A retrospective chart review quantifying breast cancer diagnosis and treatment delays among patients at a North St. Louis Community Hospital
Category: Cancer Health Disparities, Cancer Health Disparities
Conference Year: 2018
Abstract Body:
Introduction: Although breast cancer mortality has declined in recent years, the disparity between black and white women has increased. There are many factors known to contribute to this disparity, however, the contributions of diagnosis and treatment delay are understudied. Purpose: The purpose of our study is to identify if there is a disparity in diagnosis or treatment delay between black and white women with a new diagnosis of primary breast cancer at a community hospital in a socioeconomically disadvantaged region of our metropolitan area, and to identify potential points of intervention. Methods: We reviewed the medical charts of women presenting to the community hospital with primary breast cancer and who were seen by Washington University physicians between Aug. 2014 and June 2016 (n = 134). The charts of 71 white and 63 black women were reviewed. We examined time from first reported symptom to screening, screening to diagnosis, diagnosis to first treatment, patient demographics, and disease characteristics. Basic descriptive analysis and 2-sample t-tests were used to compare characteristics of women based on race. Results: We found that the median time from symptom to screening, screening to diagnosis, and diagnosis to first treatment for all women was 20, 9.5, and 29 days. Median time from symptoms to screening was 18 days for white women and 22 days for black women (p = 0.91), and from diagnosis to treatment was 27 days for white women and 34 days for black women (p = 0.06). Although black women had slightly longer delays than white women, the differences were not statistically significant. We also found that 44 (32.8%) women had significant delays (>90 days). Conclusion: We conclude that most women receive timely and efficient breast cancer diagnosis and treatment, but that there are a number of women who experience significant delays. It has been shown that delays greater than 90 days negatively impacts survival, therefore the significant number of women who fall outside this timeframe is concerning. Unlike previous studies, we did not find a statistically significant racial difference. Further work should focus on interventions with the goal of improving diagnosis and treatment time for the subset of patients with long delays.
Keywords: cancer disparities, breast cancer