Reduced healthcare access contributes to delay of care in endometrial cancer.

Autor: Fife AJ; Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, 1695 Eastchester Road, Bronx, NY 10461, United States of America. Electronic address: af1108@njms.rutgers.edu., Najor AJ; Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, 1695 Eastchester Road, Bronx, NY 10461, United States of America., Aspir TB; Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, 1695 Eastchester Road, Bronx, NY 10461, United States of America., Haines KE; Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, 1695 Eastchester Road, Bronx, NY 10461, United States of America., Vilardo NA; Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, 1695 Eastchester Road, Bronx, NY 10461, United States of America., Isani SS; Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, 1695 Eastchester Road, Bronx, NY 10461, United States of America., Cowan M; Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, 1695 Eastchester Road, Bronx, NY 10461, United States of America., Gressel GM; Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, 1695 Eastchester Road, Bronx, NY 10461, United States of America; Division of Gynecologic Oncology, Spectrum Health Cancer Center, 145 Michigan St NE, Suite 6300, Grand Rapids, MI 49503, United States of America., Ye KQ; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Block Building Room 310, Bronx, NY 10461, United States of America., Nevadunsky NS; Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, 1695 Eastchester Road, Bronx, NY 10461, United States of America., Kuo DY; Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, 1695 Eastchester Road, Bronx, NY 10461, United States of America., Lin KY; Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, 1695 Eastchester Road, Bronx, NY 10461, United States of America.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2024 Mar; Vol. 182, pp. 115-120. Date of Electronic Publication: 2024 Jan 22.
DOI: 10.1016/j.ygyno.2024.01.010
Abstrakt: Objective: We aimed to characterize delays to care in patients with endometrioid endometrial cancer and the role healthcare access plays in these delays.
Methods: A chart review was performed of patients with endometrioid endometrial cancer who presented with postmenopausal bleeding at a diverse, urban medical center between 2006 and 2018. The time from symptom onset to treatment was abstracted from the medical record. This interval was subdivided to assess for delay to presentation, delay to diagnosis, and delay to treatment.
Results: We identified 484 patients who met the inclusion criteria. The median time from symptom onset to treatment was 4 months with an interquartile range of 2 to 8 months. Most patients had stage I disease at diagnosis (88.6%). There was no significant difference in race/ethnicity or disease stage at time of diagnosis between different groups. Patients who had not seen a primary care physician or general obstetrician-gynecologist in the year before symptom onset were more likely to have significantly delayed care (27.7% vs 14.3%, p = 0.02) and extrauterine disease (20.2% vs 4.9%, p < 0.01) compared to those with established care. Black and Hispanic patients were more likely to experience significant delays from initial biopsy to diagnosis.
Conclusions: Delays exist in the evaluation of endometrial cancer. This delay is most pronounced in patients without an established outpatient primary care provider or obstetrician-gynecologist.
Competing Interests: Declaration of competing interest The authors have no conflicts of interest to report. No funding was received from any funding bodies in the public, commercial, or nonprofit sectors to perform the work described in this manuscript.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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