Determinant factors for diagnostic delay in operable breast cancer patients

M. Montella, A. Crispo, G. D Aiuto, M. De Marco, G. De Bellis, G. Fabbrocini, M. Pizzorusso, M. Tamburini, P. Silvesrtra

Research output: Contribution to journalArticle

Abstract

Randomized trials of mammographic screening have provided strong evidence that early diagnosis and treatment of breast cancer can reduce the specific mortality. Moreover, in a recent systematic review of published studies, delays of 3-6 months between symptom onset and treatment have been clearly found to be associated with lower survival rates for breast cancer patients. The aim of this study was to examine delays registered among breast cancer patients in southern Italy, in order to recognize their determining factors so as to provide women with a better opportunity for survival. The variables examined were age (<50, 50-64, ≥ 65 years), education (≤ 5, > 5 school years); symptom status at first presentation (symptomatic or asymptomatic); date of first symptom presentation; date of first consultation with a health provider; the type of health provider consulted; tumour 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 age and education: a higher risk was found for women of over 65 years age (odds ratio (OR) 2.1, 95% confidence interval (CI) 1.2-3.5) and 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 (oncologists exclusively dedicated to breast cancer operation) and other specialists (OR 3.5, 95% CI 1.5-8.4). Young age and symptomatic presentation were found to be high risk factors. Concerning tumour size in overall delay, in cases where the tumour was > 2cm the OR was 2.4 (95% CI 1.5-3.7). Our study suggests that diagnostic delay can be reduced by providing more efficient training programmes for members of the medical profession and by producing educational training programmes targeted specifically at each age category (i.e. in older women more attention to education in prevention; in younger women correct information about mammography and specialized structures).

Original languageEnglish
Pages (from-to)53-59
Number of pages7
JournalEuropean Journal of Cancer Prevention
Volume10
Issue number1
DOIs
Publication statusPublished - 2001

    Fingerprint

Keywords

  • Age
  • Breast cancer
  • Education
  • Medical delay
  • Medical profession
  • Overall delay
  • Patient delay
  • Tumour size

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Montella, M., Crispo, A., D Aiuto, G., De Marco, M., De Bellis, G., Fabbrocini, G., Pizzorusso, M., Tamburini, M., & Silvesrtra, P. (2001). Determinant factors for diagnostic delay in operable breast cancer patients. European Journal of Cancer Prevention, 10(1), 53-59. https://doi.org/10.1097/00008469-200102000-00006