Race affects breast cancer diagnostic delay more than insurance status

Race plays greater role in diagnostic delay than insurance for women with breast abnormalities, according to data presented at the 2010 AACR Conference on The Science of Cancer Health Disparities.

In a study of 983 women examined for breast cancer, Heather Hoffman, PhD, assistant professor of epidemiology and biostatistics at George Washington University School of Public Health and Health Services, and colleagues at the George Washington Cancer Institute, discovered that non-Hispanic black women and Hispanic women with government or private insurance waited more than twice as long for a definitive diagnosis than non-Hispanic white women with government or private insurance.

“We were surprised by the fact that non-Hispanic black and Hispanic women with health insurance experience greater delays than non-Hispanic white women with health insurance,” said Dr. Hoffman. “We though having health insurance would even the field among all women. Insured women should have had the same rapid evaluation regardless of race and ethnicity.”

Among those with private insurance, diagnostic delay time, or the number of days from abnormal screening to definitive diagnosis, was 15.9 days for white women, 27.1 days for black women, and 51.4 days for Hispanic women. Diagnostic delay times among those with government insurance were 11.9 days for white women, 39.4 days for black women, and 70.8 days for Hispanic women. For those without insurance, diagnostic delay times were reported as 44.5 days for white women, 59.7 days for black women, and 66.5 days for Hispanic women.

“Non-Hispanic black and Hispanic women should be the focus of breast cancer screening outreach and follow-up since they experience greater delays in diagnosis than non-Hispanic white women, regardless of type of insurance,” concluded Dr. Hoffman. “In particular, we need to investigate the barriers to rapid workup in insured non-Hispanic black and Hispanic women first and then investigate barriers in all uninsured women.”

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