Factors associated with time interval between the onset of symptoms and first medical visit in women with breast cancer

Abstract

Women presenting with advanced breast cancer tumors are common in Brazil. Little is known about factors contributing to the delay in seeking care. The aim of this study was to identify factors associated with longer time intervals between the onset of breast cancer symptoms and the first medical visit in the Federal District, Brazil. The analysis included 444 symptomatic women with incident breast cancer, interviewed between September, 2012 and September, 2014, during their admission for breast cancer treatment in nine public hospitals in the Federal District. Patients with metastatic disease at diagnosis were not included in this study. The outcome was time interval between symptom onset and the first medical visit, whether > 90 (34% of patients) or ≤ 90 days. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI). In the multivariate analysis, the > 90 day interval was significantly associated with patients not performing mammography and/or breast ultrasound in the two years prior to breast cancer diagnosis (OR = 1.97; 95%CI: 1.26-3.08), and with more advanced stages (OR = 1.72; 95%CI: 1.10-2.72). Furthermore, there was a lower chance of delay in patients with higher levels of education (OR = 0.95; 95%CI: 0.91-0.99). A relatively high proportion of breast cancer patients in the Brazilian Federal District experienced delay to attend the first medical consultation after the symptoms onset. Increasing breast cancer awareness, especially among women with low educational levels and those not participating in mammography screening programs could contribute to reduce this delay.

Prevalência e fatores associados ao diagnóstico de câncer de mama em estágio avançado

“…Como limitação do estudo, destaca-se a utilização de dados secundários que não possibilitaram a avaliação da influência de importantes variáveis no diagnóstico de câncer de mama em estágio avançado, como submissão a mamografia anterior ao diagnóstico e tempo decorrido entre os primeiros sintomas e a primeira consulta médica e/ou diagnóstico 58 , uma vez que os RHC do Brasil não coletam tais informações sistematicamente. Outra limitação que a ser mencionada é a morosa alimentação do IntegradorRHC, que, ao dificultar sua atualização com dados de anos mais recentes, impossibilitou a análise desses pelo estudo.…”

Duration of the patient interval in breast cancer and factors associated with longer delays in low‐and middle‐income countries: A systematic review with meta‐analysis

“…Detailed information about each article is included in Table S1. The majority of articles reported on studies conducted in countries in Africa (32%), 22–37 followed by South‐East Asia (30%), 38–51,71 the Middle East (20%), 52–61 Latin America (16%), 62–69 and Eastern Europe (2%) 45,70 . Two articles reported on patients from more than one country 24,45 …”

Epidemiologia da mortalidade por câncer de mama no Brasil entre os anos de 2009 e 2019 e a influência de aspectos socioeconômicos e demográficos

“…Tais dados ilustram a baixa execução desse exame, elucidando a necessidade de maior sensibilização das mulheres quanto à importância desta triagem. Além disso, a maioria das pacientes com a faixa etária descrita realizou mamografia anualmente, não atendendo às recomendações indicadas pelas normativas, fato que pode prejudicar o acesso universal a essa avaliação e, com isso, dificultar que o diagnóstico seja firmado em outros casos de suspeição aumentada (Barros et al, 2020).…”