ArticleCancer2021
Patient-reported causes of distress predict disparities in time to evaluation and time to treatment after breast cancer diagnosis.
Article in Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Annals of Surgical Oncology Landmark Series Disparities in Surgical Oncology: Breast Cancer.Annals of surgical oncology · 2025Review
- Implementing social and behavioral determinants of health data collection: insights from a pragmatic trial.JNCI cancer spectrum · 2025Article
- Association Between Delayed/Forgone Medical Care and Resource Utilization Among Women with Breast Cancer in the United States.Annals of surgical oncology · 2025Article
- Patient-Reported Distress in Individuals With Head and Neck Cancer.JAMA otolaryngology-- head & neck surgery · 2025Article
- Longitudinal Increases in Time to Surgery for Patients with Breast Cancer: A National Cohort Study.Annals of surgical oncology · 2024Article
- The Association Between Oncology Outreach and Timely Treatment for Rural Patients with Breast Cancer: A Claims-Based Approach.Annals of surgical oncology · 2024Article
- Factors influencing psychological distress among breast cancer survivors using machine learning techniques.Scientific reports · 2024Article
- Transcultural Adaptation of the Breast Cancer Awareness Measure in a Rural Border Area of Greece.Cureus · 2024Article
- Incidence and risk factors for psychological distress in adult female patients with breast cancer: a systematic review and meta-analysis.Frontiers in psychiatry · 2024Review
- Modifiable Barriers and Facilitators for Breast Cancer Care: A Thematic Analysis of Patient and Provider Perspectives.The Journal of surgical research · 2023Article
- Psychological distress in breast cancer patients during oncological inpatient rehabilitation: incidence, triggering factors and correlation with treatment-induced side effects.Archives of gynecology and obstetrics · 2023Article
- Psychometric properties of the perceived stress scale (pss-10) with breast cancer patients.Stress and health : journal of the International Society for the Investigation of Stress · 2023Article
- Disparities and barriers in the assessment of psychological distress, access to and use of psycho-oncological support in Europe: current perspectives.Frontiers in psychology · 2023Article
- "You start feeling comfortable, you just start sharing:" A qualitative study of patient distress screening in Black and White patients with endometrial cancer.Gynecologic oncology · 2023Article
- Rural-Urban Differences in Breast Cancer Surgical Delays in Medicare Beneficiaries.Annals of surgical oncology · 2022Article
- Disparities in timely treatment among young women with breast cancer.American journal of surgery · 2022Article
- Distress screening in endometrial cancer leads to disparity in referral to support services.Gynecologic oncology · 2022Article
- Review
- Characterization of Clinical Symptoms by Race Among Women With Early-Stage, Hormone Receptor-Positive Breast Cancer Before Starting Chemotherapy.JAMA network open · 2021Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundWe examined whether the National Comprehensive Cancer Network distress thermometer (DT), a patient-reported outcome measure, could be used to identify levels and causes of distress associated with racial/ethnic disparities in time to care among patients with breast cancer.
methodsWe identified women aged ≥18 years with stage 0-IV breast cancer who were diagnosed in a single health system between January 2014 and July 2016. The baseline visit was defined as the first postdiagnosis, pretreatment clinical evaluation. Zero-inflated negative binomial (ZINB) regression (modeling non-zero DT scores and DT scores = 0) and logistic regression (modeling DT score ≥ 4, threshold for social services referral) were used to examine associations between baseline score (0 = none to 10 = extreme) and types of stressors (emotional, familial, practical, physical, spiritual) after adjustment for race/ethnicity and other characteristics. Linear regression with log transformation was used to identify predictors of time to evaluation and time to treatment.
resultsA total of 1029 women were included (median baseline DT score = 4). Emotional, physical, and practical stressors were associated with distress in both the ZINB and logistic models (all P < .05). Black patients (n = 258) were more likely to report no distress than Whites (n = 675; ZINB zero model odds ratio, 2.72; 95% CI, 1.68-4.40; P < .001) despite reporting a similar number of stressors (P = .07). Higher DT scores were associated with shorter time to evaluation and time to treatment while being Black and having physical or practical stressors were associated with delays in both (all P < .05).
conclusionsPatient-reported stressors predicted delays in time to care, but patient-reported levels of distress did not, with Black patients having delayed time to care despite reporting low levels of distress. We describe anticipatory, culturally responsive strategies for using patient-reported outcomes to address observed disparities.
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