Racial differences in diagnosis, treatment, and clinical delays in a population-based study of patients with newly diagnosed breast carcinoma
Racial differences in diagnosis, treatment, and clinical delays in a population-based study of patients with newly diagnosed breast carcinoma
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DOI：
10.1002/cncr.20169
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发表时间：
2004-04-15
期刊：
影响因子：
6.2
通讯作者：
Coates, RJ
中科院分区：
文献类型：
--
作者：
Gwyn, K;Bondy, ML;Coates, RJ
背景很少有研究讨论的问题，是否延误之间的时间间隔的医疗咨询和诊断和治疗乳腺癌是更大的非洲裔美国妇女比白色妇女。作者研究了这些延迟的差异，并分析了可能导致1990年至1992年诊断为浸润性乳腺癌的20-54岁女性中存在这种差异的因素，这些女性居住在佐治亚州亚特兰大市。共有251名非洲裔美国妇女和580名白色妇女接受了采访，并审查了她们的医疗记录。作者估计了延迟时间的种族差异，并使用多分类逻辑回归来确定各种因素（社会经济和其他）对这些差异的贡献。虽然两组中的大多数妇女在初次咨询后3个月内接受了治疗，但22.4%的非洲裔美国妇女和14.3%的白色妇女的临床延迟> 3个月。与白色女性相比，非裔美国女性更容易出现诊断和治疗延迟。获得护理（以检测方法和保险状况为代表）和贫困指数部分解释了延迟时间的差异;然而，即使调整了影响因素，延迟治疗和诊断方面的种族差异仍然存在。目前的研究结果表明，在20-54岁患有乳腺癌的女性中，非洲裔美国女性和白色女性之间在延迟诊断和治疗方面存在潜在的临床显著差异。改善获得护理的机会和社会经济状况可能会在一定程度上解决这些差异，但需要进行更多的研究，以确定其他促成因素。2004年由美国癌症协会出版。
BACKGROUND. Few studies have addressed the issue of whether delays in the interval between medical consultation and the diagnosis and treatment of breast carcinoma are greater for African American women than for white women. The authors examined differences with respect to these delays and analyzed the factors that may have contributed to such differences among women ages 20-54 years who had invasive breast carcinoma diagnosed between 1990 and 1992 and who lived in Atlanta, Georgia.METHODS. A total of 251 African American women and 580 white women were interviewed and had their medical records reviewed. The authors estimated racial differences in delay times and used polytomous logistic regression to determine the contributions of various factors (socioeconomic and other) to these differences.RESULTS. Although most women in both groups were treated within 3 months of initial consultation, 22.4% of African American women and 14.3% of white women had clinical delays of > 3 months. Compared with white women, African American women were more likely to experience delays in diagnosis and treatment. Access to care (as represented by method of detection and insurance status) and poverty index partially accounted for these differences in delay time; however, racial differences in terms of delayed treatment and diagnosis remained even after adjustment for contributing factors.CONCLUSIONS. The findings of the current study suggest that among women ages 20-54 years who have breast carcinoma, potentially clinically significant differences in terms of delayed diagnosis and treatment exist between African American women and white women. Improvements in access to care and in socioeconomic circumstances may address these differences to some degree, but additional research is needed to identify other contributing factors. Published 2004 by the American Cancer Society.