Delay in breast cancer diagnosis: a Brazilian cohort study. (February 2019)

• Record Type: Journal Article
• Authors: Medeiros, G.C.; Thuler, L.C.S.; Bergmann, A.
• Is Part Of: Public health. Volume 167(2019)
• Page Start: 88
• Page End: 95
• Publication Date: 2019-02
• Subjects: Breast neoplasms -- Epidemiology -- Delayed diagnosis -- Health services accessibility -- Healthcare disparities; Public health -- Periodicals; Public health -- Periodicals; Electronic journals; 362.1
• DOI: 10.1016/j.puhe.2018.10.012
• Languages: English
• ISSNs: 0033-3506

Abstract

Abstract: Objectives: To evaluate the delay in breast cancer (BC) diagnosis and its risk factors. Study design: A cohort study of BC patients referred to treatment at oncological reference hospital, Brazil. Delay in BC diagnosis was defined as a time interval ≥90 days between the first contact with a care provider and a BC diagnosis. Methods: The association between independent variables and delay was performed by univariate analysis and multiple logistic regression. Results: Five hundred and twenty-six women were included in the study. Delay was observed in 68.8% and was associated with performing histopathological examination at oncological reference hospital (odds ratio [OR]: 3.96, 95% confidence interval [CI]: 1.91–8.20) or at another public health service (OR: 2.31; 95% CI: 1.50–3.56) and attending gynecological consultations annually (OR: 3.24; 95% CI: 1.97–5.33) or every 2–3 years (OR: 2.86; 95% CI: 1.55–5.28). Patients who presented a lump as the first sign or symptom had a lower chance of delay (OR: 0.43; 95% CI: 0.29–0.65). Conclusions: Improvements in the structure and access to health services are needed to reduce the time to diagnosis. Highlights: The delay in breast cancer diagnosis was observed in 68.8% of cases. Doctors are better prepared to investigate cases more suggestive of cancer. Mammary alterations are undervalued by health professionals. Performing the biopsy in the public healthcare system doubled the chance of delay. There are many failures in the healthcare system, especially regarding early diagnosis.