Breast cancer treatment delay and the Hispanic paradox: A SEER database analysis

Estefania Roldan-Vasquez; Samir Mitri; Kristen D Brantley; Ted A James; Ilana Schlam

doi:10.1016/j.amjsurg.2024.116135

Breast cancer treatment delay and the Hispanic paradox: A SEER database analysis

Am J Surg. 2025 Jun:244:116135. doi: 10.1016/j.amjsurg.2024.116135. Epub 2024 Dec 15.

Authors

Estefania Roldan-Vasquez¹, Samir Mitri², Kristen D Brantley³, Ted A James², Ilana Schlam⁴

Affiliations

¹ Breast Surgical Oncology, Department of Surgery. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: eroldan@bidmc.harvard.edu.
² Breast Surgical Oncology, Department of Surgery. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
³ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
⁴ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Hematology and Oncology, Tufts Medical Center, Boston, MA, USA.

PMID: 39729783
DOI: 10.1016/j.amjsurg.2024.116135

Abstract

Background: Breast cancer (BC) is the most common cancer in US women. Knowledge gaps exist regarding healthcare inequities in Hispanic BC patients. This study assessed BC characteristics and treatment patterns among Hispanics.

Methods: Hispanic and non-Hispanic white women (NHW) with invasive BC from the SEER Database (2018-2020) were included. We evaluated if Hispanic ethnicity was associated with time from diagnosis to treatment (TT) and its impact on cancer-specific survival. Treatment delay was defined as > 3 months post-diagnosis. Logistic regression, Kaplan-Meier curves, and Cox regression models were used.

Results: Among 135,690 patients, 16.5 % were Hispanic. Median TT for Hispanics was 1.5 ÷ 1.34 months vs. 1.22 ÷ 1.07 months for NHW (p < 0.001). Adjusted analysis showed Hispanics had 2.47 times higher odds of delayed TT than NHW (95 % CI: 2.29-2.66). Delayed TT worsened survival in both groups; however, within the delayed TT, Hispanics had better survival (HR: 0.52, 95 % Cl: 0.27-0.98, p = 0.045).

Conclusions: Disparities in healthcare for Hispanic patients exist; targeted interventions and public health initiatives are needed to ensure equitable care.

MeSH terms

Adult
Aged
Breast Neoplasms* / diagnosis
Breast Neoplasms* / ethnology
Breast Neoplasms* / mortality
Breast Neoplasms* / therapy
Female
Healthcare Disparities* / ethnology
Hispanic or Latino* / statistics & numerical data
Humans
Middle Aged
SEER Program
Time-to-Treatment* / statistics & numerical data
Treatment Delay
United States / epidemiology
White
White People / statistics & numerical data