Time to surgery delays: Barriers to care for black women with breast cancer

Abstract

In the United States, well-documented racial and ethnic inequities persist in cancer treatment and outcomes. 1 O'Keefe E.B. Meltzer J.P. Bethea T.N. Health disparities and cancer: racial disparities in cancer mortality in the United States, 2000-2010. Front Public Health. 2015; 3: 51 PubMed Google Scholar ,2 Aizer A.A. Wilhite T.J. Chen M.H. et al. Lack of reduction in racial disparities in cancer-specific mortality over a 20-year period. Cancer. 2014; 120: 1532-1539 Crossref PubMed Scopus (166) Google Scholar These disparities exist across the continuum of cancer care, culminating in later stages at diagnosis, need for more comprehensive therapy, and worse mortality among Black patients compared to White patients. 1 O'Keefe E.B. Meltzer J.P. Bethea T.N. Health disparities and cancer: racial disparities in cancer mortality in the United States, 2000-2010. Front Public Health. 2015; 3: 51 PubMed Google Scholar ,2 Aizer A.A. Wilhite T.J. Chen M.H. et al. Lack of reduction in racial disparities in cancer-specific mortality over a 20-year period. Cancer. 2014; 120: 1532-1539 Crossref PubMed Scopus (166) Google Scholar Notably, Black individuals with cancer have not equally benefitted from advances in contemporary oncology care, and in breast cancer specifically, the Black-White survival gap has worsened over time. 1 O'Keefe E.B. Meltzer J.P. Bethea T.N. Health disparities and cancer: racial disparities in cancer mortality in the United States, 2000-2010. Front Public Health. 2015; 3: 51 PubMed Google Scholar ,2 Aizer A.A. Wilhite T.J. Chen M.H. et al. Lack of reduction in racial disparities in cancer-specific mortality over a 20-year period. Cancer. 2014; 120: 1532-1539 Crossref PubMed Scopus (166) Google Scholar Contributors to cancer disparities are multifactorial and include: (i) barriers to access in screening and treatment; (ii) bias in cancer care delivery; and, (iii) sociodemographic differences in environment (i.e; allostatic load), genomics, health behavior, and literacy. 3 Wheeler S.B. Reeder-Hayes K.E. Carey L.A. Disparities in breast cancer treatment and outcomes: biological, social, and health system determinants and opportunities for research. Oncol. 2013; 18: 986-993 Crossref Scopus (161) Google Scholar The complexity of health disparities and longstanding cultural injustices result in modern patterns of inequitable care that are not simple to disentangle and even more challenging to resolve. 4 Bailey Z. Krieger N. Agénor M. Graves J. Linos N. Bassett M. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017; 389 Abstract Full Text Full Text PDF PubMed Scopus (1753) Google Scholar