Low-Income Women Wait Longer to Initiate Breast Cancer Treatment, Increasing Risk of Death

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(ChemotherapyAdvisor)–One in 10 women with breast cancer waited more than 60 days to initiate treatment after diagnosis, a retrospective analysis of North Carolina Medicaid enrollees published in the Journal of Clinical Oncology online November 19 has found.

Among patients with late-stage disease, this wait was associated with a significant 66% increased risk of overall death (P=0.05) and an 85% increased risk of death from breast cancer (P=0.04), noted John M. McLaughlin, PhD, MSPH, Specialty Medicines Development Group, Pfizer, Powell, OH, and colleagues from The Ohio State University, Penn State Hershey Cancer Institute, and the University of Michigan.

This study is the first to stratify patients by stage at diagnosis when examining the effect of the length of time between diagnosis and treatment initiation on survival.

The investigators conducted a retrospective analysis of North Carolina Medicaid enrollees diagnosed with breast cancer from January 1, 2000, through December, 31, 2002, in the linked North Carolina Central Cancer Registry–Medicaid Claims database; follow-up data were available through July 31, 2006.

The study cohort comprised 1,786 low-income, adult women; mean age was 61.6 years; 44.3% were racial minorities. Median time from biopsy-confirmed diagnosis to treatment initiation was 22 days.

Length of time between biopsy-confirmed breast cancer diagnosis and initiation of treatment did not affect survival among those diagnosed at early stage.

Dr. McLaughlin noted these study results are “novel” and “suggest that future research analyzing how delays in initiating treatment after a breast cancer diagnosis affect survival should carefully examine effect modification by stage at diagnosis. Results suggest that interventions should target late-stage patients to increase the timeliness of receiving breast cancer treatments and that clinicians should structure their practice settings to promptly triage and initiate treatment for patients diagnosed at late stage.

“On the basis of the study results, ensuring that women diagnosed at late stage receive their first course of treatment in less than 60 days may be one strategy to impact breast cancer outcomes.”


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