Geographical region associated with risk of delayed breast cancer treatment for black and non-black patients

The study found that black patients and patients who lived in certain areas experienced greater delays.

For cancer patients, a long delay in treatment can reduce their chances of survival. In an analysis of 2004-2017 information on breast cancer patients in North Carolina, black patients were more likely to have treatment delays than non-black patients. Also, patients who live in certain geographic areas of the state, regardless of race/ethnicity, tend to experience delays. Research published by Wiley online in cancera peer-reviewed journal of the American Cancer Society.

For the study, Katherine E. Reader Hayes, MD, MBA, MBA, and MD from UNC Comprehensive Cancer Center and colleagues examined data on patients with stage I and III breast cancer who received surgery or chemotherapy. as their first-line treatment and are listed in the Cancer Information and Population Health resource, which links cancer registry and sociodemographic data to insurance claims. The research team defined the delay as >60 days from diagnosis to first treatment.

Of the 32,626 patients, 19% were black. Investigators found that 15% of black patients experienced a delay in treatment compared to 8% of non-black patients. Also, patients who lived in certain areas of the state were more likely to be delayed, with those in the highest-risk area more likely to experience delays than those in the lowest-risk area. This was the case for both black and non-black patients.

The size of the ethnic gap in delaying treatment varied by region, from 0.0% to 9.4%.

On average, about 1 in 7 black women in our study experienced a prolonged delay, but this risk varies depending on where in the state the woman lives. These delays were not explained by the patient’s distance from cancer treatment facilities, the specific stage of cancer or type of treatment, or the insurance they had. These findings suggest that the structure of local healthcare systems, rather than the characteristics of the patients themselves, may better explain why some patients delay treatment and other adverse cancer outcomes.”

Dr. Kathryn E. Reeder Hayes, MD, MBA, MA, of UNC Lineberger Comprehensive Cancer Center

Researchers are currently developing and testing tools to help patients communicate about the delays they are facing, and to alert healthcare systems early when a patient’s cancer treatment plan is off track.


Journal reference:

Ryder Hayes, KE, et al. (2023) Ethnicity, geography, and risk of breast cancer treatment delay: a population-based study 2004-2015. cancer.

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