Impact of Changing Residence on Time to Breast Cancer Treatment

PURPOSE Studies evaluating the impact of neighborhood factors on breast cancer (BrCa) outcomes are yet to consider residential mobility or temporal changes in socioenvironmental factors. This study investigated residential mobility on time to first BrCa treatment. METHODS Females 18 years and older diagnosed with stage I to III BrCa who received their first BrCa treatment (surgery or chemotherapy) between 2013 and 2020 as a patient of a National Comprehensive Cancer Center were included in the study. Residential address history (with address history available ≥1-year prediagnosis) was integrated with annual census tract-level socioeconomic status, degree of African American segregation, and neighborhood disinvestment using spatiotemporal models of neighborhood audit items. Accelerated failure time models of time to first BrCa treatment were built to test associations with residential factors and generate time ratios and 95% CIs. RESULTS A total of 1,061 patients were eligible, of whom 14% moved at least once during follow-up (2% moved postdiagnosis). Patients who moved postdiagnosis had a 30.6% longer time to first treatment (95% CI, 7.8 to 58.1) than patients who did not move. For each standard deviation decrease in prediagnosis neighborhood socioeconomic status, the time to first treatment increased by 3.8% (95% CI, 0.9 to 6.7). No differences were observed in time to first BrCa treatment based on the degree of African American residential segregation or neighborhood disinvestment. CONCLUSION Residing in neighborhoods with poorer socioeconomic status prediagnosis and relocating postdiagnosis are two time period–specific residential factors that could adversely affect timely receipt of BrCa treatment.