ArticleClinical and investigative medicine. Medecine clinique et experimentale2009
Wait times for surgical and adjuvant radiation treatment of breast cancer in Canada and the United States: greater socioeconomic inequity in America.
Article in Clinical and investigative medicine. Medecine clinique et experimentale, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Barriers to accessing radiation therapy in Canada: a systematic review.Radiation oncology (London, England) · 2012Pooled it
- Short course radiotherapy with simultaneous integrated boost for stage I-II breast cancer, early toxicities of a randomized clinical trial.Radiation oncology (London, England) · 2012Trial
- Time From Screening to Treatment at Accredited Breast Centers in the United States.JCO oncology practice · 2025Article
- Global burden of female breast cancer and its association with socioeconomic development status, 1990-2044.Cancer reports (Hoboken, N.J.) · 2023Article
- Surgical wait times and socioeconomic status in a public healthcare system: a retrospective analysis.BMC health services research · 2022Article
- Modal lifespan and disparity at older ages by leading causes of death: a Canada-U.S. comparison.Journal of population research (Canberra, A.C.T.) · 2020Article
- Relation between socioeconomic variables and surgical, systemic and radiation treatment in a cohort of patients with breast cancer in an urban Canadian centreCanadian journal of surgery. Journal canadien de chirurgie · 2019Article
- Wait lists and adult general surgery: is there a socioeconomic dimension in Canada?BMC health services research · 2019Article
- Care of acute conditions and chronic diseases in Canada and the United States: Rapid systematic review and meta-analysis.Journal of public health research · 2019Article
- Patient Satisfaction with Wait-Times for Breast Cancer Surgery in Newfoundland and Labrador.Healthcare policy = Politiques de sante · 2016Article
- What Prevents Men Aged 40-64 Years from Prostate Cancer Screening in Namibia?Journal of cancer epidemiology · 2016Article
- The Influences of Health Insurance and Access to Information on Prostate Cancer Screening among Men in Dominican Republic.Journal of cancer epidemiology · 2016Article
- Care and survival of Mexican American women with node negative breast cancer: historical cohort evidence of health insurance and barrio advantages.Journal of immigrant and minority health · 2015Article
- A patient-centred approach toward surgical wait times for colon cancer: a population-based analysis.Canadian journal of surgery. Journal canadien de chirurgie · 2014Article
- Mediation of the effects of living in extremely poor neighborhoods by health insurance: breast cancer care and survival in California, 1996 to 2011.International journal for equity in health · 2013Article
- Preoperative delays in the US Medicare population with breast cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2012Article
- Effects of being uninsured or underinsured and living in extremely poor neighborhoods on colon cancer care and survival in California: historical cohort analysis, 1996-2011.BMC public health · 2012Article
- What are wait times to see a specialist? an analysis of 26,942 referrals in southwestern Ontario.Healthcare policy = Politiques de sante · 2012Article
- Cancer patients' concerns regarding access to cancer care: perceived impact of waiting times along the diagnosis and treatment journey.European journal of cancer care · 2012Article
- A case study and state of science review: private versus public healthcare financing.Global journal of health science · 2011Review
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
purposeThe demand for cancer care has increased among aging North American populations as cancer treatment innovations have proliferated. Gaps between supply and demand may be growing. This study examined whether socioeconomic status has a differential effect on waits for surgical and adjuvant radiation treatment (RT) of breast cancer in Canada and the US.
methodsOntario and California cancer registries provided 929 and 984 breast cancer cases diagnosed between 1998 and 2000 in diverse urban and rural places. Residence-based socioeconomic data were taken from censuses. Cancer care variables were reliably abstracted from health records: stage, receipt of surgery and RT, and waits from diagnosis to initial and initial to adjuvant treatment. Median waits were compared within- and between-country with the non-parametric Mann-Whitney U-test. Categorically long, age-adjusted wait comparisons used the Mantel-Haenszel chi-square test.
resultsThere were significant associations between lower socioeconomic status and longer surgical waits, lower access to adjuvant RT and to longer RT waits across diverse places in California. None were observed in Ontario. The two cohorts did not practically differ on access to surgery or on surgical waits. Compared with their counterparts in California, low-income Ontarians, particularly those in small urban places, gained greater access to RT, while high-income Americans had shorter waits for RT.
conclusionsThis historical study contextualized Canada's "waiting-list problems" with evidence on breast cancer care, where lower income Americans seemed to have waited as long as similar Canadians. Many more low-income Americans seemed to experience the longest wait of all for adjuvant care. They simply did not receive it. In contrast to stark American socioeconomic inequity, this study evidenced remarkable equity in Canadian breast cancer care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.