Are Breast Cancer Diagnostic Delays Linked To Ethnicity and Race?

Researchers at George Washington University School of Public Health and Health Services and at the George Washington Cancer Institute released shocking results last week. According to a recent study, in which the researchers analyzed 983 women examined for breast cancer between 1998 and 2009 from six hospitals and clinics in Washington, D.C., "race and ethnicity may affect breast cancer diagnostic delays more than insurance status for women with breast abnormalities".

Heather J. Hoffman, Ph.D., assistant professor of epidemiology and biostatistics at George Washington University School of Public Health and Health Services presented the material at the Third American Association for Cancer Research Conference on The Science of Cancer Health Disparities. The conference was held September 20 - October 2.

According to Hoffman, an analysis of hospital data shows that non-Hispanic black and Hispanic women with government or private insurance wait more than twice as long for a breast cancer diagnosis than non-Hispanic white women with government or private insurance.

Furthermore ,although an uninsured black women had to wait more than twice as long as that of black women with private insurance for a breast cancer diagnosis, black women with private insurance still had to wait "significantly longer" for their cancer to be diagnosed than white woman.

Among those with private insurance, the average time it took for a breast cancer diagnosis was "15.9 days for white women, 27.1 days for black women and 51.4 days for Hispanic women". The average diagnostic time among those with government insurance were "11.9 days for white women, 39.4 days for black women and 70.8 days for Hispanic women". Among those without insurance, the average diagnostic time was "44.5 days for white women, 59.7 days for black women and 66.5 days for Hispanic women".

When researchers started the study, they did not expect to find that race or ethnicity had any impact on the amount of time it would take a doctor to diagnose cancer. According to Hoffman, " we were surprised by the fact that non-Hispanic black and Hispanic women with health insurance experienced greater delays than non-Hispanic white women with health insurance. We thought having health insurance would even the field among all women. Insured women should have had the same rapid evaluation regardless of race and ethnicity." Following her presentation of the data at the Conference, she passionately urged for healthcare professionals to follow up with Hispanic and non-Hispanic black women after breast abnormalities are discovered and urged her colleagues to start researching this issue to discover what barriers lie between these women and a rapid breast cancer diagnosis.

I am extremely surprised by the research presented. Like the George Washington researchers, I never would have thought that the race or ethnicity of a woman would have any impact on the amount of time that it took for her to have her cancer diagnosed when health insurance is not a factor. I would be extremely interested to find out why this disparity exists and whether the research can be replicated on a larger scale. I find it hard to believe that pathologists and doctors purposely delay diagnosing breast cancer in Hispanic and non-hispanic black women and find it more likely that these delays have something to do with their preconceived notions that white women are more likely to have breast cancer. However, I do acknowledge that, while it is an appalling notion, there is still a very real possibility that the delay could be due to racism. I hope that the researchers at George Washington continue their study and delve into what might be fueling this diagnostic discrepancy. I urge healthcare professionals to make hispanic and non-hispanic black women the focus of breast cancer screening programs, and sincerely hope that the medical community will pick up the pace when diagnosing breast cancer in all women.

 

 

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