Predictive Factors for Diagnosis and Treatment Delay in Iranian Women with Breast Cancer

Abstract

Background: The growing trend of breast cancer in Iran and the adverse consequences arising from the delay in diagnosis and treatment in females has been a challenge. Objectives: This study was conducted to identify the predictors for diagnosis and treatment delay in females with breast cancer in the north of Iran. Methods: This cross-sectional study was performed on 232 patients with a definite diagnosis of breast cancer at Razi Hospital, which is the main referral centre in Guilan Province, Iran, using sequential sampling methods. Data were collected using a six-section questionnaire through interviews and medical records of the patients. Data were analyzed using descriptive statistics, logistic regression and chi square test. Results: Delays of more than one month was observed in 53% of patients and more than three months delay was observed in 31%. Of the patients with a definite diagnosis of breast cancer, 87% returned within seven days for treatment interventions. Three variables of: stage of disease (stage II: P = 0.002, OR = 7.19 and stage III: P = 0.034, OR = 1.95), lack of complementary insurance (P = 0.007, OR = 2.26) and primary insurance (P = 0.067, OR = 3.52) were important risk factors for patient delay. Knowledge and attitude regarding the symptoms of breast cancer (P = 0.007), the most important method for breast cancer diagnosis (P = 0.004), and the importance of self-examination was significantly different between patients with and without delay in the onset of treatment. Conclusions: This study showed that about one-third of patients with breast cancer had a patient delay of more than three months. In addition, 16.8% and 13% of patients experienced system delay in diagnosis and treatment, respectively. The government is responsible to not only teach people on the signs of breast cancer, but also to establish a powerful screening system for breast cancer.

Determinants of delay from cancer diagnosis to treatment initiation in a cohort of brazilian women with breast cancer

“…Only Iran presented a delay of over 100 days, similar to the result observed herein (Mirfarhadi et al, 2016).…”

“…In more specific analyses, the distance between the residence location and the hospital unit is calculated (Lopes et al, 2017;Maghous et al, 2016). Other authors consider territorial aspects, comparing, for example, rural and urban/metropolitan residents (Huo et al, 2015;Mirfarhadi et al, 2016). Between 2005 and2006 in Brazil, a high percentage of women who received breast-cancer treatment funded by the public health system travelled over 150 km from their homes to the treatment location.…”

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 …”

“…Lower socio‐economic status, education, or income, lower literacy, lack of health insurance, and residing in less densely‐populated (i.e., rural) areas were consistently related to longer patient intervals. Socio‐cultural variables related to longer patient intervals were explored in four articles and included vague symptom interpretation, 58 lack of knowledge about cancer and cancer symptoms, not believing that cancer is curable, being unfamiliar with breast self‐examination, 52 and use of complementary or alternative medicine 60 . One article documented effects of fear of cancer, spouse behavior, and carelessness on the patient interval but did not specify the direction or meaning of the effects (e.g., whether fear of cancer was related to longer or shorter patient intervals) 59 …”

Factors that Correlate with The Health Services Seeking on Breast Cancer Patients

“…The high number of women who did not make early breast cancer detection efforts had an influence on the discovery of breast cancer cases diagnosed in an advanced stage (Wang,2017). Mirfarhadi et al (2017) in his study explains that there is one predictive factor that is significantly related to the delay of diagnosis and treatment in breast cancer patients one of which is not doing breast selfexamination (SADARI) (Mirfarhadi et al, 2017).…”