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

• Published in: European journal of public health 2014-10, Vol.24 (5), p.761-767
• Main Authors: Jassem, Jacek, Ozmen, Vahit, Bacanu, Florin, Drobniene, Monika, Eglitis, Janis, Lakshmaiah, Kuntegowdanahalli C, Kahan, Zsuzsanna, Mardiak, Jozef, Pieńkowski, Tadeusz, Semiglazova, Tatiana, Stamatovic, Ljiljana, Timcheva, Constanta, Vasovic, Suzana, Vrbanec, Damir, Zaborek, Piotr
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Asia; Attitude to Health; Breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - psychology; Cities; Europe; Fear - psychology; Female; Health Behavior; Higher education; Humans; Medical diagnosis; Medical treatment; Middle Aged; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Self-Examination - psychology; Self-Examination - statistics & numerical data; Socioeconomic Factors; Surveys and Questionnaires; Time Factors; Trust - psychology
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckt131

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. 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). 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. 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.