Patient delay and stage of diagnosis among breast cancer patients in Germany – a population based study

Abstract

Early diagnosis is a tenet in oncology and should enable early treatment with the expectation of improved outcome. Extent and determinants of patient delay of diagnosis in breast cancer patients and its impact on stage of disease were examined in a population based study among female breast cancer patients in Germany. Two hundred and eighty-seven women, aged 18 to 80 years with newly diagnosed invasive symptomatic breast cancer, were interviewed with respect to the diagnostic process. Patient delay was defined as time from onset of first symptoms to first consultation of a doctor. Median patient delay was 16 days among symptomatic patients. Eighteen per cent of all breast cancer patients waited longer than 3 months before consulting a physician. Long patient delay was associated with old age, history of a benign mastopathy, obesity, and indices of health behaviour such as not knowing a gynaecologist for out-patient care and non-participation in general health screening examinations. A strong association between patient delay and stage at diagnosis was observed for poorly differentiated tumours. These results suggest that at risk groups for delaying consultation can be identified and that a substantial proportion of late stage diagnoses of poorly differentiated breast cancer cases could be avoided if all patients with breast cancer symptoms would present to a doctor within 1 month.

Sociodemographic factors and delays in the diagnosis of six cancers: analysis of data from the ‘National Survey of NHS Patients: Cancer’

“…For NHL, age was an important factor. For breast cancer, marital status and ethnic group were important factors, again strengthening the current evidence base (Tartter et al, 1999;Nosarti et al, 2000;Thongsuksai et al, 2000;Arndt et al, 2002;Meechan et al, 2002;Gwyn et al, 2004;Robertson et al, 2004). The trends in the associations using both statistical approaches were all in the same direction for each of the six cancers.…”

“…No associations have been reported with patient delays (Nosarti et al, 2000;Meechan et al, 2002) or physician delays (Tartter et al, 1999). Longer delays have been associated with older age (Arndt et al, 2002), but faster times to treatment have also been associated with increasing age (Robertson et al, 2004). Other positive findings from the literature include: African-American women having longer delays than white women (Gwyn et al, 2004), and unmarried women having longer patient delays than married women (Thongsuksai et al, 2000).…”

Uwarunkowania opóźnień w diagnostyce i terapii kobiet chorych na raka piersi w Polsce związane z postawami chorych

“…Zaobserwowano jednak pewną poprawę w zakresie obniżenia stopnia zaawansowania nowotworu w momencie rozpoznania [1], chociaż rozpoczęcie leczenia przez chore na raka piersi w Polsce nadal jest opóźnione. Opóźnienie w podjęciu leczenia nie jest wyłącznie polskim doświad-czeniem [3,[5][6][7][8][9][10][11][12][13]. Wśród przyczyn opóźnienia wymieniane są przyczyny zależne od chorych, od lekarzy oraz systemu opieki zdrowotnej [14].…”

Delays in the diagnosis of six cancers: analysis of data from the National Survey of NHS Patients: Cancer

“…(Arndt et al, 2003) 0 days (Jones et al, 1992) 4 weeks (Thongsuksai et al, 2000) 1/4 412 weeks (Thongsuksai, 2000) 1 Week (Thulesius et al, 2004) 14 days (Meechan et al, 2002) 16 days (Arndt et al, 2002) 13 days (Nosarti et al, 2000)…”