Breast cancer diagnostic delay depends more on race than insurance

(Press-News.org) MIAMI — Race and ethnicity appeared to affect diagnostic delay more than insurance status for women with breast abnormalities, as revealed by data presented at the Third American Association for Cancer Research Conference on The Science of Cancer Health Disparities, being held Sept. 30-Oct. 3, 2010.

Heather J. Hoffman, Ph.D., assistant professor of epidemiology and biostatistics at George Washington University School of Public Health and Health Services, and colleagues at the George Washington Cancer Institute, conducted a retrospective cohort study of 983 women examined for breast cancer between 1998 to 2009 at six hospitals and clinics in Washington, D.C.

Findings revealed that non-Hispanic black and Hispanic women with government or private insurance waited more than twice as long for a definitive diagnosis than non-Hispanic white women with government or private insurance.

Diagnostic delay time, or the amount of time between when abnormalities were found until a diagnosis was reached, for uninsured black women was more than twice as long as that of black women with private insurance. Although having private insurance reduced time to diagnosis for black women, they still waited significantly longer for a diagnosis than white women with private insurance.

"We were surprised by the fact that non-Hispanic black and Hispanic women with health insurance experienced greater delays than non-Hispanic white women with health insurance," Hoffman said. "We thought having health insurance would even the field among all women. Insured women should have had the same rapid evaluation regardless of race and ethnicity."

Among those with private insurance, diagnostic delay time, or the number of days from abnormal screening to definitive diagnosis, was 15.9 days for white women, 27.1 days for black women and 51.4 days for Hispanic women. Diagnostic delay times among those with government insurance were 11.9 days for white women, 39.4 days for black women and 70.8 days for Hispanic women. Finally, among those without insurance, diagnostic delay times were reported as 44.5 days for white women, 59.7 days for black women and 66.5 days for Hispanic women.

"Non-Hispanic black and Hispanic women should be the focus of breast cancer screening outreach and follow-up since they experience greater delays in diagnosis than non-Hispanic white women, regardless of type of insurance," Hoffman said. "In particular, we need to investigate the barriers to rapid workup in insured non-Hispanic black and Hispanic women first and then investigate barriers in all uninsured women."

"Health care professionals must stress follow-up with all non-Hispanic black and Hispanic women with breast abnormalities to assure they are diagnosed as soon as possible," she added.

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This work was conducted as part of the George Washington Cancer Institute's involvement with the NCI-funded national Patient Navigation Research Program, which is designed to assess whether patient navigation can reduce the time between diagnostic finding and resolution and time between diagnosis and treatment.

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The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, the AACR is the world's oldest and largest professional organization dedicated to advancing cancer research. The membership includes 32,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and more than 90 other countries. The AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants, research fellowships and career development awards. The AACR Annual Meeting attracts more than 18,000 participants who share the latest discoveries and developments in the field. Special Conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. The AACR publishes six major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; Cancer Epidemiology, Biomarkers & Prevention; and Cancer Prevention Research. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists, providing a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy.

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