Abstract
BackgroundAlthough evidence suggests worse breast cancer-specific survival associated with treatment delay beyond 90 days, little is known regarding the sociodemographic predictors of delays in cancer-directed surgery among young women with breast cancer. This is particularly notable, given that 5–10% of new diagnoses occur in younger women aged <40 years, commonly with more aggressive features than in older women. MethodsWe used the National Cancer Database (2004–2017) to assess sociodemographic disparities in delay of upfront surgery beyond 90 days among young women with non-metastatic breast cancer, using multivariable logistic regression and predictive marginal modeling. ResultsBlack women experienced treatment delays more frequently than white women (aOR: 1.93 [95% CI: 1.76–2.11], p < 0.001). Adjusted rates of treatment delay were 4.91% [95% CI: 4.51%–5.30%] and 2.60% [95% CI: 2.47%–2.74%] for Black and white women, respectively, and 2.97% [95% CI: 2.83%–3.12%], 2.36% [95% CI: 2.03%–2.68%], and 1.18% [95% CI: 0.54%–1.81%] for women from metro, urban, and rural areas, respectively. ConclusionThese results suggest that improving access to timely treatment may be leveraged as a means through which to lessen the breast cancer disparities experienced by Black women.
Published Version
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