Demystifying delays: Factors associated with timely treatment of adrenocortical carcinoma.

Background: Delays in management of adrenocortical carcinoma (ACC) may lead to worse outcomes. We assessed for delays in ACC treatment according to sociodemographic factors.

Methods: We performed a retrospective cohort study of patients treated for ACC (2010-2019) utilizing the National Cancer Database. Cox proportional hazards modeling was used to evaluate the associations between sociodemographic, geographic, and clinical factors and time to intervention from diagnosis.

Results: Across 1399 subjects treated for ACC, the median time to treatment was 27 days (IQR 15-47). Non-Hispanic Black patients (HR 0.798, p ​= ​0.033) and patients aged 40-64 years (HR 0.800, p ​= ​0.008) were at greater risk of delays in care, whereas female patients (HR 1.169, p ​= ​0.011) and those with metastatic disease (HR 1.176, p ​= ​0.010) received more timely care.

Conclusions: Older age, male sex, and Black race were associated with delays in care for ACC though these delays did not translate to worsened overall survival.