An assessment of delays in obtaining definitive breast cancer treatment in Southern Italy

M. Montella, A. Crispo, G. Botti, M. De Marco, G. De Bellis, G. Fabbrocini, M. Pizzorusso, M. Tamburini, G. D'Aiuto

Research output: Contribution to journalArticlepeer-review

Abstract

Female population is medically underserved in Southern Italy (in comparison with other Italian regions). In a recent systematic review of published studies, delays of 3-6 months between symptom onset and treatment have been clearly associated with lower survival rates for breast cancer patients. The aim of this study was to examine breast cancer delays in medically underserved patients in Southern Italy, in order to recognize their determinating factors so as to provide women with a better opportunity for survival. The variables examined were age, education, symptom status at first presentation: symptomatic and asymptomatic, date of first symptom presentation, date of first consultation with a health provider, consulted provider, tumor size and nodal status, according to the pTNM system. Time intervals were categorized into: <1 month, 1-3 months and > 3 months for patient and medical delay; 1-3 months, 3-6 months, > 6 months for overall delay. Patient delay was associated with education: a higher risk was found for women with ≤ 5 years school attendance (OR = 3.3, 95%, CI 2.0-5.6). Medical delay was seen to be associated with the professional figure: significant differences were found between senologists (oncologist exclusively dedicated to breast cancer) and other specialists (OR 3.5, 95%, CI 1.5-8.4). Age and symptomatic presentation were found to be high risk factors. Concerning tumor size in overall delay in cases > 2 cm had OR values were of 2.4 (95%, CI 1.5-3.7). In conclusion our study suggests that diagnostic delay is associated with medically underserved status and can be reduced by educating younger and less educated women, as suggested in other studies and by providing training programs for members in the medical profession.

Original languageEnglish
Pages (from-to)209-215
Number of pages7
JournalBreast Cancer Research and Treatment
Volume66
Issue number3
DOIs
Publication statusPublished - 2001

Keywords

  • Breast cancer
  • Education
  • Medical delay
  • Medical profession
  • Medically underserved
  • Overall delay
  • Patient delay
  • Tumor size

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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