时间推迟至治疗开始（TTI）的增量延迟已被证明会导致乳腺癌、结肠直肠癌（CRC）、头颈癌（HNC）、非小细胞肺癌（NSCLC）和胰腺癌的疾病特异性死亡率呈正比例增加的独立风险。研究表明，这些延迟与种族和社会经济差距有关。我们评估了患者因素和TTI之间的关联，以确定与延迟相关的因素。这是一项回顾性队列研究，在一个城市社区的学术中心对2019年1月至2021年12月被诊断为或转介接受治愈性治疗的乳腺癌、CRC、HNC、NSCLC和胰腺癌患者进行了评估。感兴趣的变量包括Charlson共病指数（CCI）分数、保险类型、语言偏好和诊断前30天住院接受治疗。使用多元逻辑回归评估了与TTI延迟（定义为TTI≥30天）有关的因素。在2,543名患者（其中69％为女性）中，平均年龄为63.4岁，TTI中位数为25天（IQR，6-44）。在多元模型中，门诊治疗而且诊断前30天没有住院治疗经验的患者在CRC（OR，2.82; 95％ CI，1.71至4.66）和NSCLC（OR，2.11; 95％ CI，1.31至3.39）上经历了显著的延迟。更高的CCI得分与HNC（OR，2.63; 95％ CI，1.04至6.66）和NSCLC（OR，1.75; 95％ CI，1.14至2.71）的延误有关。对于乳腺癌，无保险和讲西班牙语的患者（OR，1.79; 95％ CI，1.21至2.67）经历了TTI增加。我们确定了导致TTI延迟的协调/遵从（例如，治疗前30天住院）、临床（例如，上述共病）和社会经济（例如，无保险状态）预测因素，这些因素可以提供延迟缩短的干预措施。我们的数据支持证据表明TTI的延误与人口统计学和社会经济差距有关。现有的差距可能会加剧对协调/遵从问题、多重共病畏惧和较低社会经济地位患者的不利影响。

Incremental delays in time to treatment initiation (TTI) have been shown to cause a proportional, increased independent risk of disease-specific mortality for breast cancer, colorectal cancer (CRC), head and neck cancer (HNC), non-small-cell lung cancer (NSCLC), and pancreatic cancer. Studies suggest that delays are associated with racial and socioeconomic disparities. We evaluated associations between patient factors and TTI to identify those associated with delay.This is a retrospective cohort study at an urban community-based academic center of patients diagnosed with or referred for curative-intent treatment of breast cancer, CRC, HNC, NSCLC, and pancreatic cancer from January 2019 to December 2021. Variables of interest included Charlson Comorbidity Index (CCI) score, insurance type, language preference, and inpatient admission 30 days before diagnosis. Factors associated with TTI delay, defined as TTI ≥ 30 days, were assessed using multivariable logistic regression.Among 2,543 patients (69% female), the mean age was 63.4 years and the median TTI was 25 days (IQR, 6-44). Within multivariable models, patients treated as outpatient and not admitted 30 days before diagnosis experienced statistically significant greater delay for CRC (odds ratio [OR], 2.82; 95% CI, 1.71 to 4.66) and NSCLC (OR, 2.11; 95% CI, 1.31 to 3.39). Higher CCI score was associated with delay for HNC (OR, 2.63; 95% CI, 1.04 to 6.66) and NSCLC (OR, 1.75; 95% CI, 1.14 to 2.71). For breast cancer, uninsured and Spanish-speaking patients (OR, 1.79; 95% CI, 1.21 to 2.67) experienced increased TTI.Care coordination/compliance (eg, inpatient 30 days before diagnosis), clinical (eg, medical comorbidities), and socioeconomic (eg, uninsured status) predictors for delayed TTI were identified and may inform delay minimizing interventions. Our data support evidence that TTI delays are associated with demographic and socioeconomic disparities. Existing disparities are likely exacerbated by delays that disproportionately affect patients with care coordination/compliance issues, multiple comorbidities, and lower socioeconomic status.