Association between delayed diagnosis and breast cancer in advanced clinical stage at the time of consultation in four oncology centers in Medellin- Colombia, 2017. Cross-sectional study
DOI:
https://doi.org/10.18597/rcog.3410Abstract
Objective: To determine the association between delayed diagnosis and advanced clinical stage breast cancer, and to explore the factors that influence this delay. Materials and methods: Cross-sectional study of women over 18 years of age with breast cancer who attended 4 oncology centers in Medellín, Colombia, in 2017. The “Breast Cancer Delay Questionnaire” which includes sociodemographic and clinical variables as well as time intervals was used. Crude and adjusted odds ratio (OR) were estimated, using advanced clinical stage as outcome and delayed diagnosis as exposure. Results: 242 patients were included. The median time interval between the identification of the problem and the diagnostic biopsy was 104.5 days; between the identification of the problem and the first medical visit, 20 days; and between the first visit and the diagnostic biopsy, 53 days. Of all the cases, 52.1 % were diagnosed at an advanced stage. An association was found between delayed diagnosis and advanced clinical stage (OR = 2.15 95 % CI 1.21-3.79). Age above 40 was found to be a protective factor against having an advanced-stage lesion (OR = 0.35; 95 % CI: 0.14-0.83). Delayed diagnosis was associated with affiliation to the government subsidized health system (OR = 9.67; 95 % CI 2.76-33.9) and age over 40 years (OR = 2.75; 95 % CI 1.16-6.53). Conclusion: Patient education is required in order to ensure adherence to early screening programs or timely consultation whenever a sign or symptom is identified, thus allowing diagnosis at an early stage of the disease. Moreover, prospective studies are needed in order to identify factors associated with delays in treatment after the diagnosis of breast cancer, and to assess interventions designed to reduce delays in the care of this form of cancer.
Author Biographies
Diana Cristina Martínez-Pérez, Universidad de Antioquia
Magíster en Epidemiología Clínica, Universidad de Antioquia, Medellín, Colombia.
Luis Rodolfo Gómez-Wolff, Instituto de Cancerología Las Américas
Especialista en Oncología Clínica, Instituto de Cancerología Las Américas, Medellín, Colombia.
Carlos Andrés Ossa-Gómez, Hospital General de Medellín
Especialista en Mastología, Hospital General de Medellín, Medellín, Colombia.
Gilma Norela Hernández-Herrera, Universidad de Antioquia
Matemática, especialista en Epidemiología, Universidad de Antioquia, Medelllín, Colombia.
Yamile Rivas-Bedoya, Instituto de Cancerología Las Américas
Gerente en Sistemas de Información en Salud, Instituto de Cancerología Las Américas, Medellín, Colombia.
Héctor Iván García-García, Instituto de Cancerología Las Américas
Magíster en Salud Pública y Epidemiología, Universidad de Antioquia, Instituto de Cancerología Las Américas, Medellín, Colombia.
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