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Eur J Public Health. 2014 Oct;24(5):761-7. doi: 10.1093/eurpub/ckt131. Epub 2013 Sep 12.

Delays in diagnosis and treatment of breast cancer: a multinational analysis.

Author information

1
1 Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland jjassem@gumed.edu.pl.
2
2 Department of Surgery, Istanbul University, Istanbul, Turkey.
3
3 Departament of Clinical Oncology, Sf Maria Hospital, Bucharest, Romania.
4
4 Radiotherapy and Drug Therapy Center, Institute of Oncology, Vilnius University, Vilnius, Lithuania.
5
5 Department of Breast Surgery, Oncology Centre of Latvia, Riga East University Hospital, Riga, Latvia.
6
6 Department of Medical Oncology, Kidwai Memorial Institute of Oncology, India.
7
7 Department of Oncotherapy, University of Szeged, Szeged, Hungary.
8
8 2nd Department of Oncology, National Cancer Institute and Medical School of Comenius University, Bratislava, Slovak Republic.
9
9 Department of Oncology and Surgery, Medical Centre of Postgraduate Education, Otwock, Poland.
10
10 Department of Medical Oncology, Petrov Research Institute of Oncology, St. Petersburg, Russia.
11
11 Department of Medical Oncology, Institute of Oncology and Radiology, Belgrade, Serbia.
12
12 Department of Chemotherapy, Specialized Hospital for Active Treatment in Oncology, Sofia, Bulgaria.
13
13 Department of Medical Oncology, Clinic of Oncology, Zagreb University Hospital Centre, Zagreb, Croatia.
14
14 Collegium of World Economy, Warsaw School of Economics, Warsaw, Poland.

Abstract

BACKGROUND:

Reducing treatment delay improves outcomes in breast cancer. The aim of this study was to determine factors influencing patient- and system-related delays in commencing breast cancer treatment in different countries.

METHODS:

A total of 6588 female breast cancer patients from 12 countries were surveyed. Total delay time was determined as the sum of the patient-related delay time (time between onset of the first symptoms and the first medical visit) and system-related delay time (time between the first medical visit and the start of therapy).

RESULTS:

The average patient-related delay time and total delay time were 4.7 (range: 3.4-6.2) weeks and 14.4 (range: 11.5-29.4) weeks, respectively. Longer patient-related delay times were associated with distrust and disregard, and shorter patient-related delay times were associated with fear of breast cancer, practicing self-examination, higher education level, being employed, having support from friends and family and living in big cities. The average system-related delay time was 11.1 (range: 8.3-24.7) weeks. Cancer diagnosis made by an oncologist versus another physician, higher education level, older age, family history of female cancers and having a breast lump as the first cancer sign were associated with shorter system-related delay times. Longer patient-related delay times and higher levels of distrust and disregard were predictors of longer system-related delay times.

CONCLUSIONS:

The delay in diagnosis and treatment of breast cancer remains a serious problem. Several psychological and behavioural patient attributes strongly determine both patient-related delay time and system-related delay time, but their strength is different in particular countries.

PMID:
24029456
DOI:
10.1093/eurpub/ckt131
[Indexed for MEDLINE]

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