It is believed that absence of health insurance causes delay in breast cancer diagnosis, but if the following article is to be believed then this may not be true. A recent study suggests that race and ethnicity affect diagnostic delay more than insurance status in women with breast cancer. Previously, it was assumed that insured women have rapid evaluation regardless of race and ethnicity.
The investigators undertook a retrospective cohort study of 983 women. The study subjects were scrutinized for breast cancer between 1998 to 2009 at six hospitals and clinics in Washington, D.C. It was observed that non-Hispanic black and Hispanic women with government or private insurance waited more than twice as long for a definitive diagnosis as compared to non-Hispanic white women with government or private insurance. Furthermore, delay in diagnostic time or the amount of time between identification of abnormalities until a diagnosis reached for uninsured black women was more than twice as long as that of black women with private insurance. Astonishingly authors noted that non-Hispanic black and Hispanic women with health insurance went through major delays than non-Hispanic white women with health insurance.
Heather J. Hoffman, Ph.D., assistant professor of epidemiology and biostatistics at George Washington University School of Public Health and Health Services, commented, “Non-Hispanic black and Hispanic women should be the focus of breast cancer screening outreach and follow-up since they experience greater delays in diagnosis than non-Hispanic white women, regardless of type of insurance. In particular, we need to investigate the barriers to rapid workup in insured non-Hispanic black and Hispanic women first and then investigate barriers in all uninsured women. Health care professionals must stress follow-up with all non-Hispanic black and Hispanic women with breast abnormalities to assure they are diagnosed as soon as possible.”
Private insurance seemed to decrease time for diagnosis among black women, but they waited for very long than white women with private insurance. From participants with private insurance, diagnostic delay time, or the number of days from abnormal screening to definitive diagnosis, may be 15.9 days for white women, 27.1 days for black women and 51.4 days for Hispanic women. On the other hand, diagnostic delay times in those with government insurance appeared to be 11.9 days for white women, 39.4 days for black women and 70.8 days for Hispanic women. Diagnostic delay times among those without insurance probably were 44.5 days for white women, 59.7 days for black women and 66.5 days for Hispanic women.
The study was presented at the Third American Association for Cancer Research Conference on The Science of Cancer Health Disparities, being held September 30 to October 3, 2010.