Khan Muhammad Aleem, Shafique Sehrish, Khan Muhammad Taha, Shahzad Muhammad Faheem, Iqbal Sundas
Department of Nuclear Medicine Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad, Pakistan E-mail :
Asian Pac J Cancer Prev. 2015;16(1):377-80. doi: 10.7314/apjcp.2015.16.1.377.
There is strong evidence that delayed diagnosis of breast cancer is associated with poor survival. Our objectives were to determine the frequency of breast cancer patients with delayed presentation, the reasons of delay and its association with different socio-demographic variables in our North Pakistan setting.
We interviewed 315 histologically confirmed breast cancer patients. Delay was defined as more than 3 months from appearance of symptoms to consultation with a doctor. Questions were asked from each patient which could reflect their understanding about the disease and which could be the likely reasons for their delayed presentation.
39.0 % (n=123) of patients presented late and out of those, 40.7% wasted time using alternative medicines; 25.2 % did not having enough resources; 17.1 % presented late due to painless lump; 10.6% felt shyness and 6.5% presented late due to other reasons. Higher age, negative family history, < 8 school years of education and low to middle socio-economic status were significantly associated with delayed presentation (p< 0.05). Education and socioeconomic status were two independent variables related to the delayed presentation after adjustment for others (OR of 2.26, 2.29 and 95%CI was 1.25-4.10, 1.06-4.94 respectively).
Significant numbers of women with breast cancer in North Pakistan experience presentation delay due to their misconceptions about the disease. Coordinated efforts with public health departments are needed to educate the focused groups and removing the barriers identified in the study. Long term impact will be reduced overall burden of the disease in the region.
有充分证据表明乳腺癌延迟诊断与生存率低相关。我们的目标是确定在巴基斯坦北部地区乳腺癌患者延迟就诊的频率、延迟原因及其与不同社会人口统计学变量的关联。
我们对315例经组织学确诊的乳腺癌患者进行了访谈。延迟定义为从症状出现到咨询医生的时间超过3个月。向每位患者询问了一些问题，这些问题可以反映他们对疾病的了解以及可能导致他们延迟就诊的原因。
39.0%（n = 123）的患者就诊延迟，其中40.7%的患者在使用替代药物上浪费了时间；25.2%的患者没有足够的资源；17.1%的患者因无痛肿块而延迟就诊；10.6%的患者感到害羞，6.5%的患者因其他原因延迟就诊。较高年龄、阴性家族史、受教育年限<8年以及社会经济地位低至中等与延迟就诊显著相关（p<0.05）。在对其他因素进行调整后，教育程度和社会经济地位是与延迟就诊相关的两个独立变量（OR分别为2.26、2.29，95%CI分别为1.25 - 4.10、1.06 - 4.94）。
在巴基斯坦北部，相当数量的乳腺癌女性患者由于对疾病的误解而出现就诊延迟。需要与公共卫生部门共同努力，对重点人群进行教育，并消除本研究中确定的障碍。长期影响将是减轻该地区疾病的总体负担。
