Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran; Department of Epidemiology, Faculty of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran.
Colorectal Research Center, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Clin Breast Cancer. 2018 Jun;18(3):239-245. doi: 10.1016/j.clbc.2017.09.005. Epub 2017 Sep 19.
Stage of cancer at diagnosis is one of the most important factors in patient prognosis. By controlling for diagnostic delay, this study aimed to identify factors associated with late-stage breast cancer (BC).
From November 2014 to January 2017, required information on 497 patients who were newly diagnosed with BC was obtained from patients' medical records. Logistic regression was used to measure the association between cancer stage and study variables.
Only 18.3% of patients were diagnosed at stage I. The rest were diagnosed at stage II (45.5%) or higher (36.2%). Among those with ≤ 3 months' diagnostic delay, age (odds ratio [OR] = 0.96; 95% confidence interval [CI], 0.93-0.99), place of residence (OR urban/rural = 1.72; 95% CI, 1.42-1.93), income (OR high/low = 0.27; 95% CI, 0.10-0.72), performing breast self-examination (OR yes/no = 0.51; 95% CI, 0.0.26 -0.98), smoking (OR yes/no = 2.23; 95% CI, 1.37-3.62), history of chest X-ray (OR yes/no = 1.40; 95% CI, 1.16-1.98), presence of chronic diseases (OR yes/no = 1.73; 95% CI, 1.36-5.48), and, for those with a delay of > 3 months, marriage age (OR = 0.83; 95% CI, 0.73-0.94), income (OR high/low = 0.07; 95% CI, 0.008-0.63), family history of BC (OR = 3.82; 95% CI, 1.05-5.05), daily exercise (OR < 10/10-20 = 0.10; 95% CI, 0.01-0.67), and presence of chronic diseases (OR yes/no = 1.77; 95% CI, 1.73-5.07), were associated with late-stage of cancer.
Shortening the diagnostic delay can help patients receive medical treatment at an earlier disease stage, resulting in better prognosis. Smokers, younger women, and those with chronic conditions or a family history of BC should take extra caution, as they may have worse prognosis if diagnosed with cancer.
诊断时的癌症分期是影响患者预后的最重要因素之一。本研究通过控制诊断延迟，旨在确定与晚期乳腺癌（BC）相关的因素。
从 2014 年 11 月至 2017 年 1 月，从患者的病历中获取了 497 名新诊断为 BC 的患者的必要信息。使用逻辑回归来衡量癌症分期与研究变量之间的关联。
只有 18.3%的患者被诊断为 I 期。其余的被诊断为 II 期（45.5%）或更高期（36.2%）。在诊断延迟≤3 个月的患者中，年龄（比值比[OR]0.96；95%置信区间[CI]0.93-0.99）、居住地（OR 城市/农村=1.72；95%CI1.42-1.93）、收入（OR 高/低=0.27；95%CI0.10-0.72）、进行乳房自我检查（OR 是/否=0.51；95%CI0.26-0.98）、吸烟（OR 是/否=2.23；95%CI1.37-3.62）、胸部 X 射线检查史（OR 是/否=1.40；95%CI1.16-1.98）、慢性疾病史（OR 是/否=1.73；95%CI1.36-5.48），以及对于那些诊断延迟超过 3 个月的患者，结婚年龄（OR=0.83；95%CI0.73-0.94）、收入（OR 高/低=0.07；95%CI0.008-0.63）、BC 家族史（OR=3.82；95%CI1.05-5.05）、每天运动（OR<10/10-20=0.10；95%CI0.01-0.67）和慢性疾病（OR 是/否=1.77；95%CI1.73-5.07）与癌症晚期相关。
缩短诊断延迟有助于患者在疾病早期接受治疗，从而获得更好的预后。吸烟者、年轻女性以及患有慢性疾病或 BC 家族史的患者应格外小心，如果被诊断患有癌症，他们可能预后更差。
