Patient-reported causes of distress predict disparities in time to evaluation and time to treatment after breast cancer diagnosis.

摘要: BACKGROUND We examined whether the National Comprehensive Cancer Network distress thermometer (DT), a patient-reported outcome measure, could be used to identify levels and causes of associated with racial/ethnic disparities in time care among patients breast cancer. METHODS identified women aged ≥18 years stage 0-IV cancer who were diagnosed single health system between January 2014 July 2016. The baseline visit was defined as first postdiagnosis, pretreatment clinical evaluation. Zero-inflated negative binomial (ZINB) regression (modeling non-zero DT scores scores = 0) logistic score ≥ 4, threshold for social services referral) examine associations (0 = none 10 = extreme) types stressors (emotional, familial, practical, physical, spiritual) after adjustment race/ethnicity other characteristics. Linear log transformation predictors evaluation treatment. RESULTS A total 1029 included (median score = 4). Emotional, practical both ZINB models (all P < .05). Black (n = 258) more likely report no than Whites (n = 675; zero model odds ratio, 2.72; 95% CI, 1.68-4.40; .001) despite reporting similar number (P = .07). Higher shorter treatment while being having physical or delays CONCLUSIONS Patient-reported predicted care, but did not, delayed low distress. describe anticipatory, culturally responsive strategies using outcomes address observed disparities.