Evaluation of therapeutic care delay among Latina- and European-American cervical cancer survivors

ObjectivesCervical cancer (CCA) ranks among the deadliest of cancers. Globally CCA claims 275,000 lives yearly. Severe delays, in cancer diagnostic or therapeutic care, that approach ≥ 60 days negatively affect survival and survivorship outcomes. This study investigated socioeconomic and healthcare system factors influencing therapeutic care delays among cervical cancer survivors (CCS).Methods291 CCS (132 European-, 50 English-proficient (EP) Latina- and 109 limited English-proficient (LEP) Latina-Americans) were recruited from cancer registries. CCS retrospectively noted the days of delay in obtaining therapeutic care and reasons for delays.ResultsCCS who were LEP Latina-Americans, had lower income and education reported severe therapeutic delays (≥ 60 days). LEP Latina-Americans experienced delays due to financial issues, doctor's delay, and healthcare system issues (p < 0.001). Doctor and healthcare system delays significantly influenced therapeutic care delay in the logistic regression model.ConclusionsHealthcare system delays are primary contributors to ethnic differences in access to appropriately-timed care observed in this study. Healthcare professionals need to develop a fuller appreciation of the multilevel factors that contribute to healthcare barriers to better inform effective interventions to increase access to life saving care.

► Delaying cancer therapeutic care can harm prognosis, increase morbidity, reduce survival and jeopardize survivorship.
► Provider, healthcare system and coverage factors as well as socioeconomic status influenced therapeutic care delay (> 60 days).
► The findings underscore the need to intervene on multiple levels including provider education, and facilitating healthcare access and affordability.