Table 1.
Multivariable adjusted associations between patient characteristics and median delay to surgery
| Characteristic | N (%) | Median delay (95% CI) | P |
|---|---|---|---|
| Age (years) | |||
| < 50 | 35,662 (25.4) | 40.45933 (40.09947, 40.81920) | |
| 50–59 | 40,490 (28.8) | 39.15395 (38.85004, 39.45785) | < 0.001 |
| 60–69 | 37,081 (26.4) | 38.68148 (38.39365, 38.96932) | < 0.001 |
| ≥ 70 | 27,382 (19.5) | 37.55041 (37.15215, 37.94867) | < 0.001 |
| Race | |||
| White | 115,163 (81.9) | 38.10018 (37.93171, 38.26865) | |
| Black | 17,042 (12.1) | 44.72110 (44.20095, 45.24124) | < 0.001 |
| Asian | 5769 (4.1) | 40.91739 (40.00678, 41.82800) | < 0.001 |
| Other/unknown | 2641 (1.9) | 39.69614 (38.61258, 40.77969) | 0.005 |
| Ethnicity | |||
| Non-hispanic | 126,904 (90.2) | 38.84077 (38.67952, 39.00202) | |
| Hispanic | 7016 (5.0) | 43.74860 (42.84907, 44.64812) | < 0.001 |
| Unknown | 6695 (4.8) | 38.05353 (37.43627, 38.67080) | 0.015 |
| Insurance | |||
| Medicaid | 6245 (4.4) | 45.80981 (44.92331, 46.69630) | |
| Medicare | 41,365 (29.4) | 38.84621 (38.49211, 39.20031) | < .001 |
| Uninsured | 2127 (1.5) | 44.97280 (43.32993, 46.61567) | 0.371 |
| Government | 1499 (1.1) | 40.85378 (39.23582, 42.47175) | < 0.001 |
| Private | 87,763 (62.4) | 38.43473 (38.22994, 38.63952) | < 0.001 |
| Unknown | 1616 (1.1) | 41.92920 (40.00933, 43.84906) | < 0.001 |
| Education* | |||
| > 21% | 17,870 (12.7) | 40.92560 (40.40086, 41.45033) | |
| 13–20.9% | 31,550 (22.4) | 39.49544 (39.15450, 39.83639) | < 0.001 |
| 7–12.9% | 46,629 (33.2) | 39.16427 (38.91023, 39.41832) | < 0.001 |
| < 7% | 43,912 (31.2) | 37.92761 (37.60052, 38.25470) | < 0.001 |
| Missing | 654 (0.5) | 33.13101 (26.41113, 39.85090) | 0.025 |
| Annual income | |||
| < $38,000 | 18,831 (13.4) | 37.83237 (37.34633, 38.31842) | |
| $38,000–$47,999 | 27,816 (19.8) | 38.53361 (38.18661, 38.88061) | 0.010 |
| $48,000–$62,999 | 36,940 (26.3) | 38.96734 (38.66033, 39.27435) | < 0.001 |
| ≥ $63,000 | 56,337 (40.1) | 39.72927 (39.41876, 40.03977) | < 0.001 |
| Missing | 691 (0.5) | 41.68427 (35.49692, 47.87162) | 0.225 |
| Setting | |||
| Large metropolitan | 79,489 (56.5) | 40.58126 (40.36052, 40.80200) | |
| Small metropolitan | 40,922 (29.1) | 37.45615 (37.18598, 37.72633) | < 0.001 |
| Suburban | 10,438 (7.4) | 35.87115 (35.29576, 36.44654) | < 0.001 |
| Rural | 5869 (4.2) | 33.77957 (33.06795, 34.49119) | < 0.001 |
| Unknown | 3897 (2.8) | 40.93846 (40.02934, 41.84758) | 0.453 |
| Distance to treatment facility (miles) | |||
| ≤ 10 | 78,606 (55.9) | 39.07204 (38.85998, 39.28410) | |
| 11–20 | 33,342 (23.7) | 38.33902 (38.03820, 38.63984) | < 0.001 |
| 21–40 | 16,577 (11.8) | 38.51943 (38.05730, 38.98157) | 0.033 |
| > 40 | 11,360 (8.1) | 41.64152 (41.03239, 42.25065) | < 0.001 |
| Unknown | 730 (0.5) | 40.51603 (37.60348, 43.42858) | 0.334 |
| Transfer of care | |||
| No | 86,170 (61.3) | 37.54626 (37.35774, 37.73478) | |
| Yes | 39,602 (28.2) | 42.89649 (42.55887, 43.23410) | < 0.001 |
| Unknown | 14,843 (10.6) | 37.49980 (37.09325, 37.90635) | 0.837 |
| Treatment facility annual volume | |||
| 0–17 patients (1st quartile) | 8131 (5.8) | 36.38818 (35.79152, 36.98483) | |
| 18–34 patients (2nd quartile) | 18,054 (12.8) | 36.89268 (36.48508, 37.30028) | 0.156 |
| 35–67 patients (3rd quartile) | 35,074 (24.9) | 38.30192 (38.01514, 38.58870) | < 0.001 |
| > 67 patients (4th quartile) | 79356 (56.4) | 40.14092 (39.93916, 40.34269) | < 0.001 |
| Charlson Comorbidity Index | |||
| 0 | 120,676 (85.8) | 38.97912 (38.81081, 39.14743) | |
| 1 | 16,780 (11.9) | 39.19972 (38.75693, 39.64252) | 0.354 |
| 2 | 2659 (1.9) | 40.20887 (39.13911, 41.27863) | 0.027 |
| ≥ 3 | 500 (0.4) | 44.45383 (42.02711, 46.88056) | < 0.001 |
| Grade | |||
| Well differentiated | 17,357 (12.3) | 39.70864 (39.32554, 40.09175) | |
| Moderately differentiated | 47,300 (33.6) | 39.57077 (39.31976, 39.82178) | 0.547 |
| Poorly differentiated | 47,039 (33.5) | 38.43289 (38.16999, 38.69579) | < 0.001 |
| Undifferentiated/anaplastic | 3684 (2.6) | 38.67013 (37.56746, 39.77279) | 0.074 |
| Unknown | 25,235 (17.9) | 38.81639 (38.46441, 39.16837) | 0.001 |
| Surgery type | |||
| Breast conservation | 89,156 (63.4) | 34.06873 (33.85780, 34.27965) | |
| Mastectomy | 24,905 (17.7) | 42.65004 (42.18069, 43.11938) | < 0.001 |
| Mastectomy with reconstruction | 26,554 (18.9) | 52.38859 (51.89025, 52.88693) | < 0.001 |
| Receipt of radiation | |||
| Yes | 70,069 (49.8) | 38.59995 (38.34745, 38.85245) | |
| No | 70546 (50.2) | 39.49335 (39.24647, 39.74022) | < 0.001 |
| Receipt of endocrine therapy | |||
| Yes | 54,734 (38.9) | 38.41799 (38.17619, 38.65979) | |
| No | 85,881 (61.1) | 39.44978 (39.25416, 39.64541) | < 0.001 |
| Year of diagnosis | |||
| 2004 | 4758 (3.4) | 34.67071 (33.92166, 35.41976) | |
| 2005 | 5318 (3.8) | 35.42238 (34.62557, 36.21918) | 0.175 |
| 2006 | 6238 (4.4) | 35.81412 (35.11195, 36.51630) | 0.029 |
| 2007 | 7444 (5.3) | 38.54941 (37.88847, 39.21035) | < 0.001 |
| 2008 | 12,363 (8.8) | 39.08158 (38.55450, 39.60865) | < 0.001 |
| 2009 | 14,713 (10.5) | 38.80714 (38.36663, 39.24766) | < 0.001 |
| 2010 | 15,636 (11.1) | 38.51970 (38.06289, 38.97650) | < 0.001 |
| 2011 | 16,954 (12.1) | 38.85152 (38.44292, 39.26013) | < 0.001 |
| 2012 | 18,320 (13.0) | 39.64301 (39.25723, 40.02878) | < 0.001 |
| 2013 | 19,626 (14.0) | 40.41720 (40.03274, 40.80166) | < 0.001 |
| 2014 | 19,245 (13.7) | 41.17652 (40.76929, 41.58375) | < 0.001 |
CI confidence interval; OR odds ratio; Ref reference group
*Percent of adults without a high school diploma by zip code