For patients with cancer, lengthy delays in treatment can decrease their chances of survival. In an analysis of 2004-2017 information on patients with breast cancer in North Carolina, Black patients were more likely to experience such treatment delays than non-Black patients. Also, patients living in certain geographic regions of the state, regardless of race/ethnicity, tended to experience delays. 

For the study, Katherine E. Reeder-Hayes, MD, MBA, MS, of the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center and her colleagues examined data on patients with stage I-III breast cancer who received surgery or chemotherapy as their first treatment and were listed in the Cancer Information and Population Health Resource, which links cancer registry and sociodemographic data to insurance claims. The research team defined a delay as more than 60 days from diagnosis to first treatment. 

Among 32,626 patients, 19% were Black. Investigators found that 15% of Black patients experienced treatment delays compared with 8% of non-Black patients. Also, patients living in certain regions of the state were more likely to experience delays, with those in the highest-risk region being twice as likely to experience a delay as those in the lowest-risk region. This was the case for both Black and non-Black patients.  

The magnitude of the racial gap in treatment delay varied by region, from 0.0% to 9.4%.  

“On average, about 1 in 7 Black women in our study experienced a lengthy delay, but this risk varied depending on where the woman lives in the state. These delays weren’t explained by the patient’s distance from cancer treatment facilities, their specific stage of cancer or type of treatment, or what insurance they had,” says Reeder-Hayes. 

She adds, “These findings suggest that the structure of local healthcare systems, rather than characteristics of the patients themselves, may better explain why some patients experience treatment delays and other adverse cancer outcomes.” 

The researchers are currently working on developing and testing tools for helping patients communicate about delays they’re experiencing, and for alerting healthcare systems early when a patient’s cancer treatment plan may be getting off track.