Timeliness of Breast Cancer Treatment Within The Alaska Tribal Health System

J Rural Health. 2019 Mar;35(2):216-221. doi: 10.1111/jrh.12280. Epub 2017 Oct 14.

Abstract

Purpose: This study examined the time from breast cancer diagnosis to initiation of treatment among Alaska Native (AN) women. We evaluated the impact of age, cancer stage, and rural/urban residence at diagnosis.

Methods: We evaluated characteristics of women recorded in the Alaska Native Tumor Registry who received a first diagnosis of breast cancer between 2009 and 2013. Median time from diagnosis to treatment was assessed. Associations of demographic and clinical characteristics with timely initiation of treatment were evaluated using logistic regression and Cox proportional hazards models.

Results: Two hundred seventy-eight (278) AN women were diagnosed with invasive breast cancer in years 2009-2013. Mean age at diagnosis was 56.8 years (SD = 13.0). The median time from diagnosis to initiation of treatment was 23 days (P < .05) with most (94.6%, n = 263) meeting the ≤60-day guideline target. Time to treatment was not associated with rural/urban residence, age, or stage at cancer diagnosis.

Conclusion: These findings indicate that most AN women diagnosed with breast cancer within the AN Tribal Health System receive timely treatment after diagnosis.

Keywords: Alaska Native; breast cancer; health disparities; quality of treatment; rural health.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Alaska / epidemiology
  • Alaska / ethnology
  • Alaska Natives / ethnology
  • Alaska Natives / genetics
  • Alaska Natives / statistics & numerical data*
  • Analysis of Variance
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / ethnology
  • Breast Neoplasms / therapy*
  • Female
  • Humans
  • Logistic Models
  • Middle Aged
  • Odds Ratio
  • Outcome and Process Assessment, Health Care / methods
  • Registries / statistics & numerical data
  • Time Factors*
  • Time-to-Treatment / statistics & numerical data*