Ethnic differences in time to surgery for women with early stage breast cancer in Aotearoa/New Zealand: a population-based study

Background This study evaluates whether there are ethnic differences in time to surgery in women with early-stage (1 - 3a) breast cancer in four NZ urban regions between 2000 and 2020 pre- and post- Faster Cancer Treatment (FCT) implementation, which was introduced to address inequities in cancer outcomes. Methods This retrospective analysis used Te Re <overline> hita Mate <overline> Utaetae (Breast Cancer Foundation National Register), a prospectively maintained database of breast cancers from 2000 to 2020. Women with stage 3b, 3c, metastatic or bilateral cancers were excluded. Logistic regression models evaluated ethnic differences in time to surgery ( <= 31/>31 days as per FCT plan) with sequential adjustment for potential contributing factors (demographic, mode of diagnosis, tumour, treatment facility type and treatment). Subgroup analyses by pre- and post-FCT implementation date were undertaken. Findings Of the 16,365 women included, 74.1% were NZ European (NZE), 10.2% were M & auml;ori, 6.1% were Paci fi c, and 9.2% were Asian. W & auml;hine M & auml;ori (M & auml;ori women) and Paci fi c women were more likely to experience delays in surgery >31 days, compared to NZE (maximally adjusted OR: 1.18; 95% CI:1.05, 1.33 and OR:1.42; 95% CI:1.22, 1.65, respectively) - deprivation and treatment facility type contributed most to this. W & auml;hine M & auml;ori experienced delay in the public system only. The associations did not differ between the pre- and post- FCT periods. Interpretation Ethnic inequities exist with respect to time to surgery for women with early-stage breast cancer and these differences persist after FCT implementation. Copyright (c) 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).