Cancer Res Treat.  2019 Jul;51(3):1098-1106. 10.4143/crt.2018.386.

Patient and Care Delays of Breast Cancer in China

Affiliations
  • 1Department of Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China. renzef@mail.sysu.edu.cn
  • 2Department of Pathology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
  • 3Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.
  • 4Breast Tumor Center, Second Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
  • 5Department of Breast and Thyroid Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Abstract

PURPOSE
This study differentiates patient and care delays of breast cancer and explores the related factors as well as the associations with the prognosis in Guangzhou, a southern city of China.
METHODS
A cohort of female incident breast cancer patients (n=1,551) was recruited from October 2008 to March 2012 and followed up until January 1, 2016 (n=1,374) in the affiliated hospitals of Sun Yat-sen University. The factors associated with patient and care delays were analyzed with multivariable logistic models. Cox proportional hazards regression models were constructed to estimate the impacts of the delays on the prognosis.
RESULTS
There were 40.4% patient delay (≥3 months) and 15.5% care delay (≥1 month). The patient delay, but not the care delay, was significantly related to the clinical stage and consequently worsened the prognosis of breast cancer (hazard ratio, 1.45; 95% confidence interval, 1.09 to 1.91 for progression-free survival). The factors related to an increased patient delay included premenopausal status, history of benign breast disease, and less physical examination.
CONCLUSION
Patient delay was the main type of delay in Guangzhou and resulted in higher clinical stage and poor prognosis of breast cancer. Screening for breast cancer among premenopausal women may be an effective way to reduce this delay.

Keyword

Breast neoplasms; Patient delay; Care delay; Related factors; Prognosis

MeSH Terms

Breast Diseases
Breast Neoplasms*
Breast*
China*
Cohort Studies
Female
Humans
Logistic Models
Mass Screening
Physical Examination
Prognosis
Solar System
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