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Diagnostic and therapeutic delays among a multi-ethnic sample of breast and cervical cancer survivors

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Summary:

This Californian study explored diagnostic and therapeutic care delays among a multi-ethnic sample of 1377 breast and cervical cancer survivors and examined contextual factors influencing diagnostic and therapeutic care delays. The study cohort comprised 449 European American, 185 African American, 468 Latina American, and 275 Asian American survivors. Latina Americans were significantly more likely to report diagnostic delays, whereas African Americans were significantly more likely to report therapeutic delays. In terms of cancer type, cervical cancer survivors (n=679) were significantly more likely to report diagnostic and therapeutic delays compared with the 698 breast cancer survivors. “Fear of finding cancer” was the most frequently cited reason for diagnostic delays, and “medical reasons” were most frequently cited for therapeutic delays.

Comment:
The study has examined where delays occur in the cancer ‘pathway’, disparities in waiting times by ethnicity and cancer type, and potential reasons for a delay to diagnosis and treatment. I am slightly concerned that most factors have been labelled as ‘personal’ (psychological, cultural, and medical factors) when, for example, ‘medical’ issues actually lie with the clinical decision maker. A similar study is being undertaken in NZ with lung cancer pathways – it’ll be interesting to see whether the same issues occur here.
Reference: Cancer. 2010;116(13): 3195-204.
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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