Economic Crisis: A Factor for the Delayed Diagnosis of Breast Cancer

Abstract

Considering the constant increase in breast cancer patients, identifying factors that influence the moment of diagnosis is essential for optimizing therapeutic management and associated cost. The purpose of the study is to evaluate the impact of the economic crisis on the moment of a breast cancer diagnosis. This retrospective observational study analyzed a cohort of 4929 patients diagnosed with breast cancer over the course of 19 years in the Western region of Romania. The time interval was divided based on the onset of the economic crisis into 3 periods: pre-crisis (2001–2006), crisis (2007–2012), and post-crisis (2013–2019). The disease stage at the moment of diagnosis was considered either early (stages 0, I, II) or advanced (stages III, IV). Although recording a similar mean number of patients diagnosed per year during the pre- and crisis periods, a significantly higher percentage of patients were diagnosed with late-stage breast cancer during the economic crisis period compared to the previous interval (46.9% vs. 56.3%, p < 0.01). This difference was further accentuated when accounting for environmental setting, with 65.2% of patients from a rural setting being diagnosed with advanced disease during the crisis interval. An overall improvement of 12% in early-stage breast cancer diagnosis was recorded in the post-crisis period (55.7%, p < 0.001). The findings of this study support periods of economic instability as potential factors for a delay in breast cancer diagnosis and highlight the need for the development of specific strategies aimed at reducing cancer healthcare and associated financial burden in times of economic crisis.

Spatio-Temporal Variation of Lung Cancer in Crete, 1992–2013. Economic or Health Crisis?

“…Similarly, a study in Romania (12) revealed a significantly higher percentage of patients diagnosed with late-stage breast cancer during the country's economic crisis compared to the previous interval (56.3% vs. 46.9%). These findings are in accordance with the international literature, which supports that poverty is among the strongest predictors of LC since it significantly increases the risk of diagnosis at a higher age, or later stage, as well as the rapid increase in multiple morbidities [12,15,36]. Furthermore, economic deprivation may limit access to and utilization of continuous and high-quality medical care and, therefore, increase the risk of lower survival [37].…”

“…Nevertheless, there is a lack of consistency between different individual and country level health impact findings [11]. Cancer is among the chronic diseases that tend to be affected 2 of 10 during recession periods [12][13][14][15]. Lung cancer (LC) in particular is the most common example of disease-specific rates that present increasing trends in population groups living in austerity [16].…”

Pandemic Stressors and Adaptive Responses: A Longitudinal Analysis of the Quality of Life and Psychosocial Dynamics among Urothelial Cancer Patients

“…The study incorporated a comprehensive analysis of variables that extended to patients' demographics and medical history, alongside specific characteristics pertinent to urothelial cancer and cancer management data [32][33][34]. These encompassed patients' age, sex, body mass index, history of substance use, referral form, COVID-19 vaccination status, number of comorbidities, tumoral grading, and duration of hospitalization.…”

Mental Health and Contraceptive Knowledge in High Schoolers: Comparing Remote and In-Person Learning during COVID-19

“…The COVID-19 pandemic, an unprecedented global health crisis, reshaped various dimensions of society, from healthcare systems to educational infrastructures [1][2][3][4]. A prominent transition instigated by this crisis was the abrupt shift to remote learning, attempting to curb the spread of the virus while maintaining educational processes.…”