Table 2.
First Author | Population | Baseline Timepoint | Outcome Event | Sample Characteristics | Unit of measurement | Insurance Status | Covariates | Results |
---|---|---|---|---|---|---|---|---|
McLaughlin 201225 | North Carolina Medicaid System linked to the North Carolina Central Cancer Registry–Medicaid Claims database | Diagnosis | Any treatment | N=1786 Any Stage Age ≥18 Jan 2000– Dec 2002 |
≥ 60 days versus < 60 days | Medicaid | Age Race Marital status Year at diagnosis County-level metropolitan and HPSA status Stage Tumor size Hormone receptor status CCI Disability status Assisted living and home health Surgery Type Treatment Type |
Unadjusted: Treatment delay ≥6 months (nonwhite v white): OR: 1.37, 95% CI 1.01–1.86 |
Gwyn 200426 | Residents of metropolitan area of Atlanta, Georgia, SEER for case ascertainment with data abstracted from records and surveys | Diagnosis | Any treatment: Definitive surgery, initial neoadjuvant chemotherapy, or the initiation of chemotherapy or hormonal therapy for metastatic disease. | N=950 Any Stage Age 20–54 May 1990– Dec 1992 |
< 1 month v ≥ 1 month | Whites: 95.6% Private 2.1% Medicare or Medicaid 2.3% None Blacks: 79.4% Private 9.8% Medicare or Medicaid 10.7% None |
Age Insurance status Poverty Index Marital Status BMI Education level Insurance type Mammography history Method of detection Number of comorbidities Smoking status Breast self-exam Bra cup size LN status Tumor size Disease stage |
Treatment delay ≥1 month (black v white) OR 2.34; 95% CI: 1.25–4.38 |
Gorin 200627 | SEER-Medicare | Diagnosis | Any treatment: Definitive surgery, neoadjuvant chemotherapy, radiation, chemotherapy or hormonal therapy for metastatic disease. | N=49,865 Any Stage Age ≥65 Jan 1992–Dec 1999 |
<1 month, 1–2 months, > 2 months | Medicare | Age Marital status Population of city of residency Stage Hormone receptor status Tumor size Lymph node involvement Cormorbid conditions Method of cancer detection Member of HMO Year of diagnosis Physician visits per year Census tract percentage in poverty |
Treatment delays ≥1 month (black v white) OR 1.64; 95% CI: 1.40–1.94 |
Simon 201222 | Henry Ford Health System, SEER | Diagnosis | Adjuvant chemotherapy | N=2,234 Stage I–III Any Age Jan 1996-Dec2005 |
0–60 days, >60 days | Whites: 95.6% Private 2.1% Medicare or Medicaid 2.3% None Blacks 79.4% Private 9.8% Medicare of Medicaid 10.7% None Total: 61.3% Private 34.9% Medicare 3.8% Other |
Age Insurance status CCI Deprivation index |
Treatment delay > 60 days v ≤ 60 days (black v white) OR 1.18, 95% CI: 0.80–1.74 |
Vandergrift 201328 | National Comprehensive Cancer Network Outcomes Database | Diagnosis | Adjuvant chemotherapy | N=6222 Stages I–III Any Age January 2003–December 2009 |
Weeks | Total: 79% Commercial 11% Medicare 8% Medicaid 3% Other |
CCI BMI Age Stage Lymph node status Hormone receptor status HER2 status Grade LVI Pathologic upstage Number of excisional procedures Reconstruction before adjuvant therapy Received ALND Diagnostic breast US Diagnostic breast MRI 21 gene RT PCR assay Type of Diagnostic biopsy Treating institution Type of initial surgery |
Time to chemotherapy (black v white) +1.5 weeks, P < .001 |
Chavez-Macgregor 20163 | California Cancer Registry | Definitive Surgery | Adjuvant chemotherapy | Stage I–III Any Age January 1,2005–December31,2010 |
91 days or more | Total: 24,843 Private: 17772 Medicare: 1651 Military: 223 Medicaid: 4259 Not insured/self pay: 208 Unknown: 70 |
Age Sex Year of diagnosis SES, breast cancer stage, Breast cancer subtype, Marital status Type of breast surgery, whether reconstructive surgery was performed, Primary payer, Treatment at an NCI–designated cancer center |
Time to chemotherapy 91 days or more (black v white) OR, 1.38; 95% CI, 1.19–1.60 |
Hershman 200629 | SEER-Medicare | Definitive Surgery | Adjuvant chemotherapy | Stage I, II Age ≥65 1992–1999 |
<1 month, 1–2 months, 2–3 months, > 3 months | Medicare | Age Live in metropolitan area Stage Hormone receptor status Tumor Grade Comorbid conditions SES score Marital status Teaching hospital Surgery performed Radiation received |
Treatment delay ≥3 months v < 3 months (black v white) OR 1.2, 95% CI: 0.7 to 1.8 |
Fedewa 201030 | National Cancer Database | Definitive surgery | Adjuvant chemotherapy | N=107,587 Stage I–III Any Age Jan 2004 – Dec 2006 |
60 days, 90 days | Whites: 63.2% Private 33.6% Medicare 3.3% Other Blacks: 57.6% Private 37.7% Medicare 4.8% Other |
Age CCI Population without high school diploma Treatment facility type Volume of patients with breast cancer at facility Census region Insurance status Stage Hormone receptor status Year diagnosis Year diagnosis |
Treatment delay > 90 days v ≤ 90 days (black v white) RR: 1.56; 95% CI: 1.44–1.89 |
Nurgalieva 201331 | SEER-Medicare | Definitive surgery | Adjuvant chemotherapy | N= 14,380 Stages I–III January 1, 1992–Dec 31,2005 |
> 90 days | Medicare | Age Marriage status Tumor stage, size, grade Hormone receptor status Comorbidity Year of diagnosis SEER region Primary surgery and radiotherapy, and chemotherapy |
Unadjusted: Treatment delay > 60 days v ≤ 60 days (black v white) 1.07; 95% CI
0.89–1.29 Treatment delay > 90 days v ≤ 90 days (black v white) 1.05; 95% CI 0.81–1.36 |
Gagliato201432 | Breast Medical Oncology Institutional database at The University of Texas MD Anderson Cancer Center | Definitive surgery | Adjuvant chemotherapy | N=6827 Stages I–III 1997–2011 |
≤ 30 days, 31 to 60 days, and ≥ 61 days | Unknown | Age Race/ethnicity Pathologic tumor size according to TNM classification Pathologic nodal status according to TNM classification Histologic grade LVI Type of surgery Number of comorbidities (0, 1 to 2, 3 to 4, or 5+) |
Unadjusted: Treatment delay > 60 days v ≤ 60 days (black v white) 0.79; 95% CI 0.62–1.00 |