Impact of COVID-19 on Time to Treat Breast Cancer and Racial Disparities Among Women in the Military Health System From FY2018-2022.

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-10-01 DOI:10.1002/cam4.71292

Melody F Mullin, Amanda Banaag, Christian Coles, Yvonee Eaglehouse, Kangmin Zhu, Tracey P Koehlmoos

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引用次数: 0

Abstract

Background: Breast cancer is the most diagnosed cancer among women in the United States, and early identification and initiation of treatment are critical to improving outcomes. This study aims to investigate the breast cancer time to treat trends among women in the Military Health System before and during the COVID-19 pandemic and if racial or socioeconomic disparities existed in timely treatment.

Methods: A retrospective cohort study of all female MHS beneficiaries ages 18-63 years during fiscal years 2018-2022. Incident breast cancer was defined as one inpatient or three outpatient diagnoses of breast cancer within a 90-day period and no previous breast cancer diagnosis in the 3 years prior. Time to treatment was calculated in days and timely treatment was identified if received within 90 days (surgical intervention) or 120 days (chemotherapy and radiation) after initial diagnosis. Study analyses included a t-test and Kaplan-Meier curve for time to treatment and an adjusted modified Poisson regression for the relative risk of timely treatment.

Results: A cohort of 14,286 women with incident breast cancer was identified; 94% received timely treatment. The average time to treatment was greater during the pandemic period (47.7 days, 95% CI = 46.6-48.7) compared to the pre-pandemic period (44.8 days, 95% CI = 43.7-45.9). Regression results indicated no difference in the likelihood of timely treatment in the pandemic period (0.99 aRR, 0.98-1.01 95% CI), no racial or socioeconomic disparities, and timely treatment was more likely to be received in the direct care setting (aRR = 1.04, 95% CI = 1.01-1.07).

Conclusion: Despite facing access to care challenges compounded by the COVID-19 pandemic, the MHS was able to provide timely treatment to women for incident breast cancer. In addition, this study observed no racial or socioeconomic disparities in the timely treatment of breast cancer in a population with equal access to care.

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2019冠状病毒病对乳腺癌治疗时间的影响以及2018-2022财年军队卫生系统中女性的种族差异

背景：乳腺癌是美国女性中诊断最多的癌症，早期识别和开始治疗对改善预后至关重要。本研究旨在调查在2019冠状病毒病大流行之前和期间，军队卫生系统女性乳腺癌治疗时间的变化趋势，以及在及时治疗方面是否存在种族或社会经济差异。方法：对2018-2022财政年度18-63岁的所有女性MHS受益人进行回顾性队列研究。偶发性乳腺癌的定义是在90天内一次住院或三次门诊诊断出乳腺癌，并且在此之前的3年内没有乳腺癌诊断。以天为单位计算治疗时间，初诊后90天（手术干预）或120天（化疗加放疗）内接受治疗，确定及时治疗。研究分析包括治疗时间的t检验和Kaplan-Meier曲线，以及及时治疗相对风险的调整修正泊松回归。结果：14286名女性乳腺癌患者被纳入队列；94%的患者得到了及时治疗。与大流行前（44.8天，95% CI = 43.7-45.9）相比，大流行期间的平均治疗时间（47.7天，95% CI = 46.6-48.7）更长。回归结果显示，在大流行期间及时治疗的可能性没有差异（aRR = 0.99, 95% CI = 0.98-1.01），没有种族或社会经济差异，在直接护理环境中更有可能得到及时治疗（aRR = 1.04, 95% CI = 1.01-1.07）。结论：尽管COVID-19大流行加剧了获得护理的挑战，但MHS仍能够及时为患乳腺癌的妇女提供治疗。此外，本研究发现，在平等获得护理的人群中，乳腺癌的及时治疗没有种族或社会经济差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.