WOMEN'S HEALTH
May 8, 2013

Breast Cancer's Bad Odds

Race is a predictor of survival rate in women with breast cancer. But other factors can affect one’s odds of survival.

A breast cancer diagnosis is never good news, but the news is even worse for some. Non-white women have to wait longer to get treatment for breast cancer than white women do, a recent study has found, and the delay can be dangerous.

The same is true of women who are poor. According to the study, anyone of lower socioeconomic class, no matter their racial background, saw longer delays before they received treatment. This is more than a case of prejudice and injustice. When delays are very long (more than six weeks), they can translate into an increased risk for mortality.

Researchers looked at the health records of over 8,800 young women in California between the ages of 15 and 39 who were diagnosed with breast cancer between 1997 and 2006. They were interested in how long women waited between the date of their diagnosis and the official date that treatment began. They called this the tracking treatment delay time, or TDT.

The authors broke the data down by race, socioeconomic status (SES), and insurance type. Hispanic and African-American women tended to have to wait longer for treatment than white women: for both groups, the odds of waiting more than six weeks were roughly half that of white women — 15.3%, compared to just 8.1%.

Women of lower SES also had a much greater likelihood of waiting more than six weeks for treatment to begin. Over twice as many poor women had to wait as compared to women of greater means. Women who had no insurance or public insurance also had to wait longer:17.8% had to wait six weeks or more, while only 9.5% of women with private insurance had to wait.

Young women accounted for relatively few breast cancer cases (5-6%) in this study, but their overall five-year survival rate was the lowest. So if you are a young woman who is uninsured, poor, Black, or Hispanic, the risk is even greater.

An editorial accompanying the study, which is published in the Journal of the American Medical Association, points out, “We should all work on eliminating these disparities in an effort to improve the health of our nation.” How that will happen is not straightforward, but perhaps the Affordable Healthcare Act will be at least a small step in the right direction.

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