Nouws Sónia, Brandão Mariana, Fontes Filipa, Pereira Susana, Dias Teresa, Ribeiro Ana Isabel, Lunet Nuno, Peleteiro Bárbara
a EPIUnit - Instituto de Saúde Pública, Universidade do Porto , Porto , Portugal.
b Instituto Português de Oncologia do Porto Francisco Gentil , Porto , Portugal.
Women Health. 2019 Jul;59(6):601-614. doi: 10.1080/03630242.2018.1539430. Epub 2018 Nov 21.
Delays in detection, diagnosis and treatment may lead to poorer prognosis in women with breast cancer. We quantified time intervals from first detection (FD) to diagnosis (D) and first treatment (FT) and identified associated factors. We studied 282 patients diagnosed with breast cancer during 2012 at the Breast Clinic of the Portuguese Institute of Oncology in Porto, Portugal using face-to-face interview and medical records. Associations of sociodemographic and clinical characteristics with time intervals was computed using adjusted percentage differences (adjPD) after logarithmic transformation, odds ratios (adjOR) for comparing the highest and lowest thirds of the distribution and 95 percent confidence intervals (CI) for both measures, using linear and logistic regression, respectively. The median times between FD and D and FT were 31 and 44 days, respectively. Significantly longer periods between FD and D were found in symptomatic women (adjPD = 99.5, 95 percent CI: 37.1, 190.0; adjOR = 3.16, 95 percent CI: 1.57, 6.33). More advanced stage was associated with shorter intervals between D and FT (adjPD = -33.8, 95 percent CI: -44.2, -21.5; adjOR = 0.14, 95 percent CI: 0.05, 0.34). Although some differences according to clinical characteristics were observed, they did not seem to translate into inequities in access to public healthcare in this group of women.
乳腺癌女性患者在检测、诊断和治疗方面的延迟可能会导致预后较差。我们对从首次检测(FD)到诊断(D)以及首次治疗(FT)的时间间隔进行了量化,并确定了相关因素。我们对2012年期间在葡萄牙波尔图肿瘤研究所乳腺诊所诊断为乳腺癌的282名患者进行了研究,采用面对面访谈和病历资料。使用对数转换后的调整百分比差异(adjPD)、比较分布最高和最低三分之一的比值比(adjOR)以及这两种测量方法的95%置信区间(CI),分别通过线性回归和逻辑回归计算社会人口统计学和临床特征与时间间隔的关联。FD与D以及FD与FT之间的中位时间分别为31天和44天。有症状的女性在FD与D之间的时间明显更长(adjPD = 99.5,95% CI:37.1,190.0;adjOR = 3.16,95% CI:1.57,6.33)。疾病分期越晚,D与FT之间的时间间隔越短(adjPD = -33.8,95% CI:-44.2,-21.5;adjOR = 0.14,95% CI:0.05,0.34)。尽管观察到了一些根据临床特征的差异,但在这组女性中,这些差异似乎并未转化为获得公共医疗保健方面的不公平。