Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, M/C 923, Chicago, IL 60612, USA.
Cancer Epidemiol Biomarkers Prev. 2010 Mar;19(3):640-7. doi: 10.1158/1055-9965.EPI-09-0997. Epub 2010 Mar 3.
Despite current recommendations for women to be screened for breast cancer with mammography every 1 to 2 years, less than half of all newly diagnosed breast cancers are initially detected through screening mammography. Prompt medical attention to a new breast symptom can result in earlier stage at diagnosis, yet many patients delay seeking medical care after becoming aware of a breast symptom.
In a population-based study of breast cancer, we examined factors potentially associated with patient delay in seeking health care for a breast symptom among 436 symptomatic urban breast cancer patients (146 white, 197 black, and 95 Hispanic). Race/ethnicity, socioeconomic status, health care access and utilization, and misconceptions about the meaning of breast lumps were the key independent variables.
Sixteen percent of patients reported delaying more than 3 months before seeking medical advice about breast symptoms. Misconceptions about breast lumps and lacking a regular provider, health insurance, and recent preventive care were all associated with prolonged patient delay (P < 0.005 for all). Misconceptions were much more common among ethnic minorities and women of lower socioeconomic status.
Reducing patient delay and disparities in delay will require educating women about the importance of getting breast lumps evaluated in a timely manner and providing greater access to regular health care.
尽管目前建议女性每 1 至 2 年通过乳房 X 光检查进行乳腺癌筛查，但所有新诊断的乳腺癌中只有不到一半最初是通过筛查性乳房 X 光检查发现的。对新出现的乳房症状及时进行医疗关注可以使诊断时更早处于早期阶段，但许多患者在发现乳房症状后会延迟寻求医疗护理。
在一项基于人群的乳腺癌研究中，我们研究了与 436 名有症状的城市乳腺癌患者（146 名白人、197 名黑人、95 名西班牙裔）在出现乳房症状后寻求医疗护理方面的患者延迟相关的潜在因素。种族/民族、社会经济地位、医疗保健的可及性和利用情况以及对乳房肿块含义的误解是关键的独立变量。
16%的患者报告说，在寻求有关乳房症状的医疗建议之前，他们会延迟超过 3 个月。对乳房肿块的误解以及缺乏定期就诊者、医疗保险和最近的预防性护理都与患者延迟时间延长有关（所有 P 值均<0.005）。误解在少数民族和社会经济地位较低的女性中更为常见。
要减少患者的延迟并缩小延迟方面的差距，需要教育女性及时评估乳房肿块的重要性，并提供更多获得定期医疗保健的机会。
