ArticleCancer2019
Race and delays in breast cancer treatment across the care continuum in the Carolina Breast Cancer Study.
Article in Cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 2 of them syntheses that pooled it.
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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
46 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Disparities in Breast Cancer Treatment and Reconstruction Among Native Hawaiian and Pacific Islander Women: Systematic Review and Meta-Analysis.Journal of surgical oncology · 2025Pooled it
- Health system factors that influence diagnostic and treatment intervals in women with breast cancer in sub-Saharan Africa: a systematic review.BMC public health · 2021Pooled it
- Impact of the diagnosis-surgery interval on survival outcomes and development of a nomogram for predicting survival in early-stage cervical cancer: a Surveillance, Epidemiology, and End Results database analysis.Journal of gynecologic oncology · 2026Article
- Racial disparities and utilization trends of first-line targeted therapies for metastatic breast cancer.JNCI cancer spectrum · 2026Article
- Disparities in Disease Presentation and Treatment Initiation for De Novo Metastatic Breast Cancer.JAMA network open · 2026Article
- A Bayesian-driven approach to identify racial inequities in longitudinal care delivery.NPJ digital medicine · 2025Article
- Inequality in Female Breast Cancer Relative Survival Rates between White and Black Women in the United States.Journal of racial and ethnic health disparities · 2025Article
- Hidden figures underlying quality measures: revealing hidden racial inequalities in end-of-life cancer care delivery: a cohort study.Lancet regional health. Americas · 2025Article
- Applying a Novel Measure of Community-Level Healthcare Access to Assess Breast Cancer Care Timeliness.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Non-English Language Preference and Breast Cancer Outcomes.JAMA network open · 2025Article
- Demystifying delays: Factors associated with timely treatment of adrenocortical carcinoma.American journal of surgery · 2025Article
- A latent class assessment of healthcare access factors and disparities in breast cancer care timeliness.PLoS medicine · 2024Article
- Dose delay, dose reduction, and early treatment discontinuation in Black and White women receiving chemotherapy for nonmetastatic breast cancer.The oncologist · 2024Article
- Longitudinal Increases in Time to Surgery for Patients with Breast Cancer: A National Cohort Study.Annals of surgical oncology · 2024Article
- Racial Disparities in Receipt of Guideline-Concordant Care in Older Adults With Early Breast Cancer.JAMA network open · 2024Article
- Does structural racism impact receipt of NCCN guideline-concordant breast cancer treatment?Breast cancer research and treatment · 2024Article
- Minorities Face Delays to Pancreatic Cancer Treatment Regardless of Diagnosis Setting.Annals of surgical oncology · 2024Article
- Article
- Ethnic inequities in use of breast conserving surgery and radiation therapy in Aotearoa/New Zealand: which factors contribute?Breast cancer research and treatment · 2024Article
- Psychosocial and supportive care concerns of young women living with advanced breast cancer: baseline findings from a prospective virtual support intervention study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundAfter controlling for baseline disease factors, researchers have found that black women have worse breast cancer survival, and this suggests that treatment differences may contribute to poorer outcomes. Delays in initiating and completing treatment are one proposed mechanism.
methodsPhase 3 of the Carolina Breast Cancer Study involved a large, population-based cohort of women with incident breast cancer. For this analysis, we included black women (n = 1328) and white women (n = 1331) with stage I to III disease whose treatment included surgery with or without adjuvant therapies. A novel treatment pathway grouping was used to benchmark the treatment duration (surgery only, surgery plus chemotherapy, surgery plus radiation, or all 3). Models controlled for the treatment pathway, age, and tumor characteristics and for demographic factors related to health care access. Exploratory analyses of the association between delays and cancer recurrence were performed.
resultsIn fully adjusted analyses, blacks had 1.73 times higher odds of treatment initiation more than 60 days after their diagnosis in comparison with whites (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.04-2.90). Black race was also associated with a longer treatment duration. Blacks were also more likely to be in the highest quartile of treatment duration (OR, 1.69; 95% CI, 1.41-2.02), even after adjustments for demographic and tumor characteristics (OR, 1.31; 95% CI, 1.04-1.64). A nonsignificant trend toward a higher recurrence risk was observed for patients with delayed initiation (hazard ratio, 1.44; 95% CI, 0.89-2.33) or the longest duration (hazard ratio, 1.17; 95% CI, 0.87-1.59).
conclusionsBlack women more often had delayed treatment initiation and a longer duration than whites receiving similar treatment. Interventions that target access barriers may be needed to improve timely delivery of care.
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