Article title:Determinants of breast cancer treatment delay differ for African American and White women
Journal name: Cancer Epidemiology, Biomarkers, and Prevention
Authors: Sasha A. McGee, Danielle D. Durham, Chiu-Kit Tse, Robert C. Millikan
Corresponding author: Sasha McGee, University of North Carolina at Chapel Hill,
Study Variables
Variables obtained from the baseline interview and quality-of-life questionnaire
From the baseline interview and quality-of-life questionnaire we collected data on self-reported race (White, Black/African American, American Indian, Eskimo, Asian/Pacific Islander, Other) and Hispanic ethnicity (yes or no), and education (0-12 years, but not a high school graduate; high school graduate; some college; technical or business school; college graduate; post-graduate or professional degree). Current employment status and changes in employment as a result of one's breast cancer diagnosis, respectively, were assessed based on responses (yes or no) to the following two questions: “Have you been working since your diagnosis of breast cancer? This includes full-time or part-time, paid or unpaid work, as well as self-employment” and “Did you lose your job due to your diagnosis of breast cancer?” Information on the total family income for the prior year (<$5,000, $5,000-$10,000, $10,000-$15,000, $15,000-$20,000, $20,000-$30,000, $30,000-$50,000, $50,000-$100,000, >$100,000), current marital status (never married or lived as married [“never married”]; married/living as married [“married”]; widowed or separated/divorced/no longer living as married [“formerly married”]), and the number of people supported by the family income was also collected. Information on current insurance coverage was requested and potential responsesto this question included “none”, or 1 or more of the following choices: “private health insurance purchased on your own or by your husband or partner”, “private health insurance from your employer or workplace or that of your husband or partner” (includes TRICARE, the Department of Defense heath care program), “Medicaid”, “Medicare”, and “any other insurance that covered part of your medical bills.” Insurance categories were created as follows: private [obtained from an employer or through the workplace, purchased by the individual or their partner, either alone or in combination with another type(s) of coverage], Medicare [Medicare either alone or in combination with another type(s) of coverage except employer-based insurance], Medicaid [Medicaid either alone or in combination with any other type(s) of coverage except private and Medicare], or none.
Healthcare access in the past 10 years was assessed based on whether there had ever been a time in which they wanted to see a doctor but could not because of financial issues (yes or no) or transportation issues (yes or no). Information related to the breast cancer included first-degree (mother, sister, or daughter) and second-degree (grandmother, granddaughter, aunt, or half-sister) family history, how the cancer was first detected (lump: self-detected, lump: detected by spouse, lump: detected by a doctor or nurse, suspicious finding on a routine mammogram, ultrasound exam, or other, in which case the participant specified the exact means of detection), and the presence or absence of physical signs or symptoms at the time of diagnosis (pain or discomfort, nipple discharge, change in the skin of the breast, as well as two additional responses specified by the participant). The degree of emotional and functional well-being (“not at all”, “a little bit”, “somewhat”, “quite a bit”, or “very much”) was assessed based on responses to the following statements in the quality-of-life questionnaire: 1) I am satisfied with how I am coping with my illness, and 2) I have accepted my illness.
Variables obtained from the cancer registry, medical records
The participant’s age at diagnosis was determined from the cancer registry records and confirmed through data abstracted from the medical records. Trained abstractors confirmed the date of the CNB and recorded information on the dates and types of treatments received, including surgeries, chemotherapy, hormone therapy, and radiation. For participants who underwent mastectomy, the abstractors documented whether immediate reconstruction was performed. Information on the American Joint Committee on Cancer (AJCC) disease stage was also obtained from the medical records.