Delay in the diagnosis and treatment of breast cancer in Vietnam.
Adolescent
Adult
Age Factors
Aged
Breast Neoplasms
/ diagnosis
Delayed Diagnosis
/ psychology
Early Detection of Cancer
Female
Health Knowledge, Attitudes, Practice
Health Services Accessibility
Humans
Incidence
Middle Aged
Patient Acceptance of Health Care
Rural Population
Socioeconomic Factors
Time-to-Treatment
Vietnam
/ epidemiology
Young Adult
Vietnam
breast cancer
delay in diagnosis and treatment
delay time
patient barriers
Journal
Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
revised:
13
08
2021
received:
10
06
2021
accepted:
17
08
2021
pubmed:
20
10
2021
medline:
18
3
2022
entrez:
19
10
2021
Statut:
ppublish
Résumé
Delays in diagnosis and treatment from first noticeable breast cancer symptoms are associated with poor outcomes. Understanding the reasons and barriers for patients' delay in seeking medical care is critical to mitigating the problem. In-person surveys were conducted among 462 women, aged 18-79, with incident breast cancer cases, recruited from two cancer hospitals in North Vietnam. Delay, defined as the time interval between symptom recognition to the diagnosis and initiation of treatment equal to or exceeding 3 months, was categorized as follows: no delay (<3 months), moderate delay (3-8 months), and serious delay (≥9 months). Multivariable multinomial logistic regression was applied in data analyses. Over one-quarter patients (31.5%) experienced moderate delays, and close to one-fifth (17.5%) experienced serious delays. Adjusted odds ratios and 95% confidence intervals for moderate and serious delays were 5.60 (3.00-10.47) and 4.25 (2.05-8.85) for financial and physical barriers, respectively. Moderate delay was positively associated with psychological barriers (5.55 [1.75-17.57]) and lack of proper knowledge (3.15 [1.47-6.74]). The associations of barriers with delays in diagnosis and treatment appeared stronger among women living in rural areas. A lack of proper knowledge was significantly associated with delay among young women (<45 years old) and those with high incomes, while psychological barriers were significantly associated with delay among older women (≥45 years old). Delays in diagnosis and treatment are common among Vietnamese breast cancer patients and are affected by several noted barriers. Proper policy needs to be developed to address this public health issue.
Sections du résumé
BACKGROUND
Delays in diagnosis and treatment from first noticeable breast cancer symptoms are associated with poor outcomes. Understanding the reasons and barriers for patients' delay in seeking medical care is critical to mitigating the problem.
METHODS
In-person surveys were conducted among 462 women, aged 18-79, with incident breast cancer cases, recruited from two cancer hospitals in North Vietnam. Delay, defined as the time interval between symptom recognition to the diagnosis and initiation of treatment equal to or exceeding 3 months, was categorized as follows: no delay (<3 months), moderate delay (3-8 months), and serious delay (≥9 months). Multivariable multinomial logistic regression was applied in data analyses.
RESULTS
Over one-quarter patients (31.5%) experienced moderate delays, and close to one-fifth (17.5%) experienced serious delays. Adjusted odds ratios and 95% confidence intervals for moderate and serious delays were 5.60 (3.00-10.47) and 4.25 (2.05-8.85) for financial and physical barriers, respectively. Moderate delay was positively associated with psychological barriers (5.55 [1.75-17.57]) and lack of proper knowledge (3.15 [1.47-6.74]). The associations of barriers with delays in diagnosis and treatment appeared stronger among women living in rural areas. A lack of proper knowledge was significantly associated with delay among young women (<45 years old) and those with high incomes, while psychological barriers were significantly associated with delay among older women (≥45 years old).
CONCLUSION
Delays in diagnosis and treatment are common among Vietnamese breast cancer patients and are affected by several noted barriers. Proper policy needs to be developed to address this public health issue.
Identifiants
pubmed: 34664428
doi: 10.1002/cam4.4244
pmc: PMC8559509
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
7683-7691Subventions
Organisme : FIC NIH HHS
ID : D43 TW009337
Pays : United States
Organisme : NCI NIH HHS
ID : P50 CA098131
Pays : United States
Organisme : NCI NIH HHS
ID : P20 CA210300
Pays : United States
Informations de copyright
© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Références
PLoS One. 2017 Apr 27;12(4):e0176394
pubmed: 28448541
Psychooncology. 2012 Dec;21(12):1316-23
pubmed: 23208839
Eur J Public Health. 2014 Oct;24(5):761-7
pubmed: 24029456
J Oncol. 2012;2012:121873
pubmed: 22956949
CA Cancer J Clin. 2021 May;71(3):209-249
pubmed: 33538338
Cancer Control. 2019 Jan-Dec;26(1):1073274819863802
pubmed: 31319695
Glob Health Action. 2018;11(1):1435344
pubmed: 29473488
Br J Cancer. 2015 Mar 31;112 Suppl 1:S35-40
pubmed: 25734380
Br J Gen Pract. 2001 Dec;51(473):967-71
pubmed: 11766868
J Biomed Inform. 2019 Jul;95:103208
pubmed: 31078660
Br J Cancer. 2009 Dec 3;101 Suppl 2:S18-23
pubmed: 19956158
Surg Clin North Am. 2013 Apr;93(2):299-308
pubmed: 23464687
BMC Cancer. 2018 Mar 21;18(1):312
pubmed: 29562894
Cancer. 2014 Jan 1;120(1):20-5
pubmed: 24347383
Salud Publica Mex. 2009;51 Suppl 2:s270-85
pubmed: 19967283
BMJ Open. 2020 Mar 24;10(3):e035173
pubmed: 32209632
Br J Cancer. 2011 Nov 8;105(10):1474-9
pubmed: 21989188
BMC Public Health. 2020 Jun 19;20(1):962
pubmed: 32560711
Lancet. 1999 Apr 3;353(9159):1119-26
pubmed: 10209974
Asia Pac J Clin Nutr. 2018;27(1):19-28
pubmed: 29222878
Cancer Med. 2021 Nov;10(21):7683-7691
pubmed: 34664428
BMC Cancer. 2015 Dec 23;15:1000
pubmed: 26698112
Cancer. 2015 Jul 1;121(13):2198-206
pubmed: 25809536
J Clin Nurs. 2009 Jul;18(14):2020-9
pubmed: 19207801
Psychooncology. 2014 Jul;23(7):749-57
pubmed: 24352798
Cancer Res Treat. 2019 Jul;51(3):1098-1106
pubmed: 30428639
Front Public Health. 2014 Jul 29;2:87
pubmed: 25121080
J Thorac Oncol. 2021 Sep;16(9):1443-1448
pubmed: 34425998
World J Clin Oncol. 2014 Aug 10;5(3):465-77
pubmed: 25114860