What is known?
Delays to breast cancer treatment can lead to more aggressive and extensive treatments, increased psychological distress and poorer survival. We know that socio-economic disadvantage is associated with later detection and longer wait times for diagnosis. However, the factors associated with the interval between diagnosis and treatment have received less attention.
What is new?
We explored the individual and area level factors associated with the interval between diagnosis and first treatment in a population-based cohort of women diagnosed with breast cancer in Queensland, Australia between 2010 and 2013.
The median interval between breast cancer diagnosis and first treatment was 15 days. One in six women wait longer than 30 days for treatment following diagnosis, where Cancer Australia recommends surgery within 30 days for those not receiving neoadjuvant therapy.
Longer intervals were associated with a lack of private health insurance, lower pre-diagnostic income, first treatments other than breast conserving surgery, and those residing outside a major city. Importantly, there were dependencies between these factors, suggesting that effects across multiple factors accumulate, potentially harming breast cancer outcomes.
What does this mean?
Many of the differences we observed were small, however, some of these same factors have been associated to screening and diagnostic delay, and an accumulation of delays at multiple stages along the diagnostic and treatment pathway may harm outcomes.
Consequences of variation in cancer treatment and care can take years to manifest and identify. The data reported here is relevant to understanding current inequalities in breast cancer outcomes in Queensland, Australia, and potentially, more broadly wherever socio-economic gradients resemble those in this study. Identifying effective strategies to reduce the disparity in wait times for breast cancer treatment faced by socioeconomically disadvantaged women should remain a priority.
Contact: James Retell
Reference: [Retell JD, Cameron JK, Aitken JF, Youl P, Pyke C, Dunn J, Chambers S, Baade PD. Individual and area level factors associated with the breast cancer diagnostic-treatment interval in Queensland, Australia. Breast Cancer Research and Treatment]