Study: Black Women With Breast Cancer Experience Longer Treatment Than White Women

CHAPEL HILL, North Carolina – One in seven black women with breast cancer had delays in starting treatment, and black women also had a prolonged duration of treatment, according to a study led by researchers at UNC’s Lineberger Comprehensive Cancer Center. .

In the diary Cancer, Melissa Troester, PhD, Marc Emerson, PhD, and colleagues report that black women were more likely than white women (13.4% vs. 7.9%) that the onset of care was delayed at least 60 days after diagnosis. Black women were also more likely to have a longer duration of treatment, as were women under 50 of all races.

The study evaluated a variety of patient-reported factors for their impact on delaying onset or prolonging duration. Although access to care, tumor status, and socioeconomic status affected treatment initiation times, these factors had a greater impact on the duration of care. It was also notable that socioeconomic status was not as strongly related to treatment delay as race.

“Our study found that black women experienced delays in both initiation and duration of treatment more often than white women. Even among women with low socioeconomic status, we still saw fewer delays among white women, underscoring the disparate experience of black women, who seem to experience unique barriers, “said Emerson, first author of the paper and postdoctoral fellow at UNC Lineberger and UNC Gillings.

Although they have a similar risk of developing breast cancer, black women are 42% more likely than white women to die from the disease. Among women under 45, the death rate for black women is more than double that of white women.

The researchers analyzed the course of care of 2,841 women enrolled in the Phase III Carolina Breast Cancer Study, which is part of a population-based study that UNC Lineberger and UNC Gillings School of Global Public Health launched in 1993 to investigate how the causes , treatments, and long-term results of breast cancer differ between white and black women. The women included in the new analysis were between 24 and 74 years of age at the time of diagnosis, had stage 1, 2 or 3 breast cancer, and about half were black.

The study used latent class analysis to group women according to a wide range of factors related to socioeconomic status, barriers to accessing care and treatments, and other patient factors that contribute to racial disparities. This aggregation allowed the researchers to consider how aggregate factors can work together to define health care experiences.

“Describing and studying the complex set of factors that influence women’s health care experience is challenging, but this approach helps develop a more complex understanding,” said Troester, lead author of the study and professor of epidemiology at the UNC Gillings and Professor of Pathology and Laboratory Medicine at UNC School of Medicine. “We found that the duration of treatment was a sensitive indicator of access. This suggests that in addition to helping patients start treatment on time, we also need to work to improve access so that treatment is not prolonged.”

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In addition to Troester and Emerson, the other authors on the article are Yvonne Golightly, PhD, and Alison Aiello, PhD, UNC Gillings; Katherine Reeder-Hayes, MD and Ugwuji Maduekwe, MD, UNC Lineberger; Xiaming Tan, PhD, and Andrew Olshan, PhD, UNC Lineberger and UNC Gillings; and Marian Johnson-Thompson, PhD, Susan G. Komen Advocate for the Scientific Steering Committee.