Diagnostic pathways for breast cancer in 10 International Cancer Benchmarking Partnership (ICBP) jurisdictions: an international comparative cohort study based on questionnaire and registry data. Issue 12 (15th December 2022)

• Record Type: Journal Article
• Authors: Vedsted, Peter; Weller, David; Zalounina Falborg, Alina; Jensen, Henry; Kalsi, Jatinderpal; Brewster, David; Lin, Yulan; Gavin, Anna; Barisic, Andriana; Grunfeld, Eva; Lambe, Mats; Malmberg, Martin; Turner, Donna; Harland, Elizabeth; Hawryluk, Breann; Law, Rebecca-Jane; Neal, Richard D; White, Victoria; Bergin, Rebecca; Harrison, Samantha; Menon, Usha
• Other Names: author non-byline.; Falborg Alina Zalounina author non-byline.; Barisi Andriana author non-byline.; Gavin Anna author non-byline.; Knudsen Anne Kari author non-byline.; Hawryluk Breann author non-byline.; Anandan Chantelle author non-byline.; Donnelly Conan author non-byline.; Brewster David H author non-byline.; Weller David author non-byline.; Turner Donna author non-byline.; Harland Elizabeth author non-byline.; Grunfeld Eva author non-byline.; Fourkala Evangelia Ourania author non-byline.; Jensen Henry author non-byline.; Boylan Jackie author non-byline.; Kelly Jacqueline author non-byline.; Moore Kerry author non-byline.; Davis Maria Rejmyr author non-byline.; Malmberg Martin author non-byline.; Lambe Mats author non-byline.; Bucher Oliver author non-byline.; Vedsted Peter author non-byline.; Bergin Rebecca author non-byline.; Law Rebecca-Jane author non-byline.; Neal Richard D author non-byline.; Almberg Sigrun Saur author non-byline.; Kearney Therese author non-byline.; Kalsi Jatinderpal author non-byline.; Cairnduff Victoria author non-byline.; Hammersley Victoria author non-byline.; White Victoria author non-byline.; Menon Usha author non-byline.; Lin Yulan author non-byline.; author non-byline.; Coebergh Jan Willem author non-byline.; Emery Jon author non-byline.; Bergström Stefan author non-byline.; Essink-Bot Marie-Louise author non-byline.; MacLeod Una author non-byline.;
• Is Part Of: BMJ open. Volume 12:Issue 12(2022)
• Publication Date: 2022-12-15
• Subjects: Breast tumours -- Epidemiology -- Adult oncology -- International health services -- PUBLIC HEALTH; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2021-059669
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: A growing body of evidence suggests longer time between symptom onset and start of treatment affects breast cancer prognosis. To explore this association, the International Cancer Benchmarking Partnership Module 4 examined differences in breast cancer diagnostic pathways in 10 jurisdictions across Australia, Canada, Denmark, Norway, Sweden and the UK. Setting: Primary care in 10 jurisdictions. Participant: Data were collated from 3471 women aged >40 diagnosed for the first time with breast cancer and surveyed between 2013 and 2015. Data were supplemented by feedback from their primary care physicians (PCPs), cancer treatment specialists and available registry data. Primary and secondary outcome measures: Patient, primary care, diagnostic and treatment intervals. Results: Overall, 56% of women reported symptoms to primary care, with 66% first noticing lumps or breast changes. PCPs reported 77% presented with symptoms, of whom 81% were urgently referred with suspicion of cancer (ranging from 62% to 92%; Norway and Victoria). Ranges for median patient, primary care and diagnostic intervals (days) for symptomatic patients were 3–29 (Denmark and Sweden), 0–20 (seven jurisdictions and Ontario) and 8–29 (Denmark and Wales). Ranges for median treatment and total intervals (days) for all patients were 15–39 (Norway, Victoria and Manitoba) and 4–78 days (Sweden, Victoria and Ontario). The 10% longest waits ranged between 101 and 209 days (Sweden and Ontario). Conclusions: Large international differences in breast cancer diagnostic pathways exist, suggesting some jurisdictions develop more effective strategies to optimise pathways and reduce time intervals. Targeted awareness interventions could also facilitate more timely diagnosis of breast cancer.