Caplan LS, Helzlsouer KJ, Shapiro S, Wesley MN, Edwards BK.
Reasons for delay in breast cancer diagnosis.
Prev Med 1996;25(2):218-24.

The authors studied system delay, the time between the initial medical consultation and the establishment of a diagnosis, in breast cancer patients. A total of 367 female breast cancer patients from the National Cancer Institute’s Black/ White Cancer Survival Study were studied. Almost 40% of women reported delays of at least 4 weeks.

“Whites were significantly more likely than blacks to be asymptomatic at initial presentation. The median system delay was 11.6 weeks, about 11 weeks for blacks and 13 weeks for whites. Blacks were significantly more likely than whites to have advanced disease. There is a suggestion that blacks tended to have longer system delay than whites with stage I disease (P=0.08), while whites had longer system delay than blacks with stage 2N1 or 3 diseases (P<0.005). …Among the system-mediated delays, appointment delays were more common than physician inaction overall and between visits 1 and 2 for blacks, while physician inaction was the more common reason between all the visits for whites.”

“These results seem to indicate that black women have poorer access to care than white women, making it more difficult to get appointments.”