34038 Race associated with delays in time to initial treatment and radiation for patients with mycosis fungoides: A retrospective, cross-sectional analysis of the National Cancer Database from 2004-2017

Abstract

Background: Studies have shown that Black patients (BPs) with mycosis fungoides (MF) have a poorer prognosis when compared with White patients (WPs), controlling for socioeconomic factors and types of treatment. However, differences in the time to treatment (TTT) between BPs and WPs with MF using the National Cancer Database (NCDB) have not been studied. Objective: To compare the TTT between BPs and WPs with MF within the NCDB, controlling for sex, age, median household income by zip code, insurance, stage, and type of treatment. Methods: A retrospective, cross-sectional analysis of patients diagnosed with MF from 2004 to 2017 within the NCDB was performed. Univariate logistic regression was used to compare TTTs, sociodemographic characteristics (SDCs), and stage by race. Multivariate logistic regression was used to evaluate TTT after controlling for type of treatment, SDCs, and stage. Results: Of the 8095 patients diagnosed with MF from 2004 to 2017, 593 (7.33%) BPs and 2467 (30.48%) WPs met the inclusion criteria. On multivariate analyses, BPs were more likely to receive their initial treatment (OR = 1.33, 95% CI 1.02–1.74) and radiation (OR = 2.46, 95% CI 1.11–5.46) >90 days after their diagnosis of MF compared with WPs. Conclusions: Delays in time to initial treatment and radiation for BPs persisted despite controlling for SDCs and stage. These delays may contribute to the poorer prognosis experienced by BPs with MF, as previously reported. Exploring why BPs with MF receive delayed care despite controlling for SDCs and stage may lead to important health care reform and reduced health disparities.