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


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.

DOI: 10.1093/eurpub/ckt131

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@article{Jassem2014DelaysID, title={Delays in diagnosis and treatment of breast cancer: a multinational analysis.}, author={Jacek Jassem and Vahit Ozmen and Florin Bacanu and Monika Drobnienė and Jānis Eglītis and Kuntegowdanahalli Chinnagiriyappa Lakshmaiah and Zsuzsanna Kah{\'a}n and Jozef Mardiak and Tadeusz Pieńkowski and Tatiana Yu. Semiglazova and Ljiljana Stamatovi{\'c} and Constanta Timcheva and Suzana Vasovi{\'c} and Damir Vrbanec and Piotr Zaborek}, journal={European journal of public health}, year={2014}, volume={24 5}, pages={761-7} }