• J Natl Med Assoc · Jan 2022

    Review

    Factors delaying chemotherapy in patients with breast cancer at a safety-net hospital.

    • Annie Tang, Ananya Mittal, Colin M Mooney, Amal L Khoury, Anna Chiang, Nicole Lai, and Kevin B Knopf.
    • Department of Surgery, University of California San Francisco, East Bay- Highland Hospital: 1411 E 31(st), QIC: 22134, Oakland CA, 94602 USA. Electronic address: annie.tang@ucsf.edu.
    • J Natl Med Assoc. 2022 Jan 1; 113 (6): 706-712.

    BackgroundDespite advances in healthcare and improved chemotherapy, disparities in breast cancer outcomes continue to persist. Our aim was to evaluate socioeconomic factors that may impact timing of treatment for patients receiving chemotherapy in underserved communities.MethodsA review of patients with breast cancer who received neoadjuvant or adjuvant chemotherapy from 2015-2019 was conducted at a safety-net hospital. The primary outcomes were times from diagnosis to chemotherapy and surgery. Clinicodemographic factors including race, age, clinical stage, primary language, comorbidities, and median income by zip code were collected. Multivariable regression analysis was performed to evaluate for factors associated with the primary outcomes.ResultsOne hundred patients were identified. For the neoadjuvant group, median time from diagnosis to chemotherapy and surgery was 52 ± 34 days and 256 ± 59 days, respectively. For the adjuvant group, median time from diagnosis to surgery and chemotherapy was 24.5 ± 18 days and 94.5 ± 53 days, respectively. Non-English language and older age were associated with increased time to chemotherapy in the adjuvant group (p < 0.05). Language and age were not associated with increased time to surgery in both groups. Race, age, comorbidities, and income were not associated with delay in treatment in either groups.ConclusionsOlder age and non-English language were associated with prolonged time from surgery to adjuvant chemotherapy. Targeted interventions directed at patient education and decreasing language barriers especially post-operatively may decrease delays in treatment and subsequently reduce disparities seen in the breast cancer population.Copyright © 2021. Published by Elsevier Inc.

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