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Instituto Nacional de Salud Pública

2009, Number 5

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salud publica mex 2009; 51 (5)

Patient delay among Colombian women with breast cancer

Piñeros M, Sánchez R, Cendales R, Perry F, Ocampo R

Language: Spanish
References: 41
Page: 372-380
PDF size: 126.93 Kb.


ABSTRACT

Objective. Characterize diagnosis and treatment of breast cancer in Bogota, Colombia and examine the extent and determinants of patient delay. Material and Methods. Using a census approach we identified 1 106 women with breast cancer. Information was gathered through personal interviews and the review of medical records. Patient delay was defined as the time elapsed from first symptoms to initial consultation Results. More than 80% of the women (902) consulted due to symptoms; the majority had advanced-stage disease. Patient delay was established in 20.3% and the main related factors were older age, lack of social security and advanced clinical stage. Higher education in patients was associated with reduced delays. Discussion. Women do not recognize breast cancer symptoms. Patient delay and related factors are similar to those found in other studies. There is an urgent need to develop communication and education strategies regarding breast cancer symptoms and early detection.


REFERENCES

  1. Robles SC, Galanis E. Breast cancer in Latin America and the Caribbean. Rev Panam Salud Publica 2002;11(3):178-185.

  2. Schwartsmann G. Breast cancer in South America: challenges to improve early detection and medical management of a public health problem. J Clin Oncol 2001;19(18 Suppl):118S-124S.

  3. Pineros M, Hernandez G, Bray F. Increasing mortality rates of common malignancies in Colombia: an emerging problem. Cancer 2004;101(10):2285-2292.

  4. Murillo R, Piñeros M, Hernández G. Atlas de mortalidad por cáncer en Colombia. Bogotá: Imprenta Nacional, 2004.

  5. Ferlay J, Bray F, Pisani P, Parkin DM. GLOBOCAN 2002 Cancer Incidence, Mortality and Prevalence Worldwide, version 2.0. Lyon: IARC Press, 2004;Vol 5.

  6. Asociación Colombiana de Empresas de Medicina Integral. Situación actual y retos del sistema de aseguramiento de la salud en Colombia. ACEMI 2008 October 22 [consulted 2009 May 20]. Available at: URL: www.alami.org/subidos/documentos3/

  7. Anderson BO. Breast healthcare and cancer control in limited-resource countries: a framework for change. Nat Clin Pract Oncol 2006;3(1):4-5.

  8. Richards MA, Westcombe AM, Love SB, Littlejohns P, Ramirez AJ. Influence of delay on survival in patients with breast cancer: a systematic review. Lancet 1999;353(9159):1119-1126.

  9. Ramirez AJ, Westcombe AM, Burgess CC, Sutton S, Littlejohns P, Richards MA. Factors predicting delayed presentation of symptomatic breast cancer: a systematic review. Lancet 1999;353(9159):1127-1131.

  10. Facione NC, Miaskowski C, Dodd MJ, Paul SM. The self-reported likelihood of patient delay in breast cancer: new thoughts for early detection. Prev Med 2002;34(4):397-407.

  11. Boffetta P, Parkin DM. Cancer in developing countries. CA Cancer J Clin 1994;44(2):81-90.

  12. Malik IA, Gopalan S. Use of CAM results in delay in seeking medical advice for breast cancer. Eur J Epidemiol 2003;18(8):817-822.

  13. Arndt V, Sturmer T, Stegmaier C, Ziegler H, Dhom G, Brenner H. Patient delay and stage of diagnosis among breast cancer patients in Germany -- a population based study. Br J Cancer 2002;86(7):1034-1040.

  14. Burgess CC, Ramirez AJ, Richards MA, Love SB. Who and what influences delayed presentation in breast cancer? Br J Cancer 1998;77(8):1343-1348.

  15. Meechan G, Collins J, Petrie K. Delay in seeking medical care for self-detected breast symptoms in New Zealand women. N Z Med J 2002;115(1166):U257.

  16. Contreras NR, Valdeiglesias N. Demora en el diagnóstico de cáncer de mama: factores de la paciente. Hospital EsSalud Cusco 1986-1999. Situa 2000(15). [Consultado 2009 marzo 20]. Available at: http://sisbib.unmsm. edu.pe/BVRevistas/situa/2000_n15/diagnostico.htm

  17. Harirchi I, Ghaemmaghami F, Karbakhsh M, Moghimi R, Mazaherie H. Patient delay in women presenting with advanced breast cancer: an Iranian study. Public Health 2005;119(10):885-891.

  18. Lannin DR, Mathews HF, Mitchell J, Swanson MS, Swanson FH, Edwards MS. Influence of socioeconomic and cultural factors on racial differences in late-stage presentation of breast cancer. JAMA 1998;279(22):1801-1807.

  19. Mandelblatt J, Andrews H, Kerner J, Zauber A, Burnett W. Determinants of late stage diagnosis of breast and cervical cancer: the impact of age, race, social class, and hospital type. Am J Public Health 1991;81(5):646-649.

  20. Arndt V, Sturmer T, Stegmaier C, Ziegler H, Dhom G, Brenner H. Socio-demographic factors, health behavior and late-stage diagnosis of breast cancer in Germany: a population-based study. J Clin Epidemiol 2001;54(7):719-727.

  21. Hansen RP, Olesen F, Sorensen HT, Sokolowski I, Sondergaard J. Socioeconomic patient characteristics predict delay in cancer diagnosis: a Danish cohort study. BMC Health Serv Res 2008;8:49.

  22. Neal RD, Allgar VL. Sociodemographic factors and delays in the diagnosis of six cancers: analysis of data from the “National Survey of NHS Patients: Cancer”. Br J Cancer 2005;92(11):1971-1975.

  23. Friedman LC, Kalidas M, Elledge R, Dulay MF, Romero C, Chang J, et al. Medical and psychosocial predictors of delay in seeking medical consultation for breast symptoms in women in a public sector setting. J Behav Med 2006;29(4):327-334.

  24. Unger-Saldaña K, Infante-Castaneda C. Delay of medical care for symptomatic breast cancer: A literature review. Salud Publica Mex 2009;51(Suppl 2):270-285.

  25. UICC International Union Against Cancer. TNM Classification of Malignant Tumours. 6th ed. USA: Wiley & Sons, 2002.

  26. Thongsuksai P, Chongsuvivatwong V, Sriplung H. Delay in breast cancer care: a study in Thai women. Med Care 2000;38(1):108-114.

  27. Montazeri A, Ebrahimi M, Mehrdad N, Ansari M, Sajadian A. Delayed presentation in breast cancer: a study in Iranian women. BMC Womens Health 2003;3(1):4.

  28. Ojeda G, Ordoñez M, Ochoa LF. Encuesta Nacional de Demográfía y Salud 2005. Bogota, DC, Colombia: Profamilia, 2007.

  29. Instituto Nacional de Cancerología. Recomendaciones para la detección temprana del cáncer de mama en Colombia. Guías de práctica clínica. Bogota: INC, 2006:1.

  30. Charry LC, Carrasquilla G, Roca S. Equity regarding early breast cancer screening according to health insurance status in Colombia. Rev Salud Publica 2008;10(4):571-582.

  31. Reynolds P, Hurley SE, Quach AT, Rosen H, Von BJ, Hertz A, et al. Regional variations in breast cancer incidence among California women, 1988-1997. Cancer Causes Control 2005;16(2):139-150.

  32. Kogevinas M, Pearce N, Susser M, Boffetta P. Social inequalities and cancer: a summary by the editors. Scientific Publication No. 138. Lyon: IARC, 2009:1-16.

  33. Baquet CR, Commiskey P. Socioeconomic factors and breast carcinoma in multicultural women. Cancer 2000;88(5 Suppl):1256-1264.

  34. Wiesner C. Determinantes psicológicos, clínicos y sociales del diagnóstico temprano del cáncer de mama en Bogotá, Colombia. Rev Col Cancerol 2007;11(1):13-22.

  35. Rodriguez MA, Ward LM, Perez-Stable EJ. Breast and cervical cancer screening: impact of health insurance status, ethnicity, and nativity of Latinas. Ann Fam Med 2005;3(3):235-241.

  36. Murillo R, Díaz S, Sánchez O, Perry F, Piñeros M, Poveda C, et al. Pilot Implementation of Breast Cancer Early Detection Programs in Colombia. Breast Care 2009;29-32.

  37. Montazeri A, Vahdaninia M, Harirchi I, Harirchi AM, Sajadian A, Khaleghi F, et al. Breast cancer in Iran: need for greater women awareness of warning signs and effective screening methods. Asia Pac Fam Med 2008;7(1):6.

  38. Ukwenya AY, Yusufu LM, Nmadu PT, Garba ES, Ahmed A. Delayed treatment of symptomatic breast cancer: the experience from Kaduna, Nigeria. S Afr J Surg 2008;46(4):106-110.

  39. Timko C. Seeking medical care for a breast cancer symptom: determinants of intentions to engage in prompt or delay behavior. Health Psychol 1987;6(4):305-328.

  40. Barry D. Differential recall bias and spurious associations in case/ control studies. Stat Med 1996;15(23):2603-2616.

  41. Lewis BG, Halm EA, Marcus SM, Korenstein D, Federman AD. Preventive services use among women seen by gynecologists, general medical physicians, or both. Obstet Gynecol 2008;111(4):945-952.




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