The SLUMS examination has validity similar to that of the MoCA and STMS for the detection of MCI, dementia, and MCI or dementia according to the CDR.

Similar to disparities seen at the national and state levels, African American women in St. Louis, Missouri have higher breast cancer mortality rates than their Caucasian counterparts. We examined breast cancer treatment (regimens and timing) in a sample of African American breast cancer patients diagnosed between 2000 and 2008 while residing in a North St. Louis cluster (eight zip codes) of late stage at diagnosis. Data were obtained from medical record extractions of women participating in a mixed-method study of breast cancer treatment experiences. The median time between diagnosis and initiation of treatment was 27 days; 12.2% of the women had treatment delay over 60 days. These findings suggest that treatment delay and regimens are unlikely contributors to excess mortality rates for African American women diagnosed in early stages. Conflicting research findings on treatment delay may result from the inconsistent definitions of treatment delay and variations among study populations. Breast cancer treatment delay may reduce breast cancer survival; additional research is needed to better understand the points at which delays are most likely to occur and develop policies, programs, and interventions to address disparities in treatment delay. There may also be differences in treatment-related survivorship quality of life; approximately 54% of the women in this sample treated with mastectomies received breast reconstruction surgery. Despite the high reconstruction rates, most women did not receive definitive completion. African American women have higher reconstruction complication rates than Caucasian women; these data provide additional evidence to suggest a disparity in breast reconstruction outcomes by race.

Introduction: Breast cancer mortality rates in the metropolitan St. Louis area are higher than those of Missouri as a whole or the United States. Similar to national trends, African American women in St. Louis have higher mortality rates than their Caucasian counterparts. Differences in the receipt of timely breast cancer treatment have been posited to be a factor that contributes to the disparity in breast cancer mortality between African American and Caucasian women. A cluster of late-stage breast cancer diagnoses has been identified in women living in North St. Louis, a predominantly African American area of St. Louis. Previous studies have shown that significant breast cancer diagnosis delays were occurring in woman referred from the St. Louis Safety Net System. The current study was carried out to examine treatment delay in a cohort of African American women diagnosed with breast cancer in North St. Louis between 2000 and 2008. Methods: Data were obtained from medical record extractions for 85 women who participated in a study funded by Susan G. Komen for the Cure that also included qualitative semi-structured interviews to determine breast cancer treatment histories. Medical records were examined for information about the type, timing, and sequence of breast cancer treatment. All of the women were treated within a local urban academic medical system. Treatment delay was calculated from the date of biopsy to the initiation of treatment and chi square tests were used to examine bivariate associations between demographic or clinical factors and treatment delay. Results: The median treatment delay was 26.5 days; 12.2% of the women had treatment delay over 60 days. This percentage is below the National Breast and Cervical Early Detection Program benchmark which states that no more than 20% of women should have a treatment delay of over 60 days. There were no statistically significant associations between demographic or clinical factors and treatment delay. Discussion: North St. Louis has the most concerning health and community indicators in the St. Louis area. In spite of the fact that this cohort of women resided in North St. Louis at diagnosis, there was no evidence of breast cancer treatment delay. These findings suggest that it is possible to treat racial and ethnic minority women with breast cancer without treatment delay, regardless of demographic factors. Delay in breast cancer treatment affects patient survival and is a vital area of breast cancer treatment research. More multidisciplinary approaches are needed to fully understand the many factors that contribute to breast cancer treatment delay so that interventions can be developed to improve outcomes in all breast cancer patients, particularly for African American women who suffer higher mortality rates despite lower incidence rates. Citation Format: Shahnjayla K. Connors, Melody Goodman, Neeraja Chavakula, Lailea Noel, Sarah Gehlert. Treatment delay among African American women in St. Louis, Missouri. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr C49. doi:10.1158/1538-7755.DISP13-C49