A study led by UNC Lineberger Comprehensive Cancer Center researchers has quantified the healthcare inequities in cancer care. According to the team, one in seven Black women with breast cancer had delays in starting treatment. Compared to white women with breast cancer, Black women also had extended duration of treatment, say the scientists.
Their findings, reported in the journal Cancer, point toward the biases and discrimination that are systematized in the United States healthcare system. With Black women almost twice times as likely as white women to have a 60+ day delay in their treatment following diagnosis ((13.4% vs. 7.9%), Black women are 42% more likely to die from the disease.
Melissa Troester, Ph.D., and Marc Emerson, Ph.D., led the study. Emerson commented: "Our study found that Black women experienced delays in both treatment initiation and duration more often than white women. Even among women with low socioeconomic status, we still saw fewer delays among white women, underscoring the disparate experience of Black women, who appear to experience unique barriers."
The team looked at data from 2,841 women enrolled in the Carolina Breast Cancer Study Phase III. The data is part of a population-based study that has been following the causes, treatments, and long-term outcomes of breast cancer differ between Black and white women since 1993. Roughly half of the participants in the study were Black and all participants had stage 1, 2, or 3 breast cancer.
The authors say they used aggregated analyses in order to assess women based on their socioeconomic status, barriers to accessing care and treatments, as well as other patient factors that contribute to racial disparities.
"Describing and studying the complex set of factors that influence women's health care experience is a challenge, but this approach helps develop a more complex understanding," said Troester, the study's senior author and professor of epidemiology at the UNC Gillings. "We observed that the duration of treatment was a particularly sensitive indicator of access. This suggests that in addition to helping patients start treatment on time, we also have to work toward improving access so treatment doesn't drag on."
In their findings, the team noted that access to care, tumor status, and socioeconomic status affected treatment start times, but had an overall bigger impact on the length of care patients received. They also found that socioeconomic status was not as strongly associated with treatment delay as was race.
Sources: Cancer, Eureka Alert