Gulzar Faisal, Akhtar Muhammad Shoaib, Sadiq Rafshan, Bashir Sajid, Jamil Sajida, Baig Shahid Mahmood
Department of Pharmacology, College of Pharmacy, University of Sargodha, Sargodha, Punjab, Pakistan,
Department of Pharmacology, Faculty of Pharmacy, The University of Lahore, Lahore, Punjab, Pakistan,
Cancer Manag Res. 2019 Jan 29;11:1087-1096. doi: 10.2147/CMAR.S180388. eCollection 2019.
Delay in seeking health care by breast cancer patients is associated with advanced stage of disease at presentation and poor survival rates. This study aimed to identify the reasons for delayed presentation and their association with various sociodemographic variables.
A total of 200 female patients with abnormal clinical findings, ie, lump or palpable mass, were consecutively invited for this study. Diagnostic delay was defined as a consultation with a health care provider more than 3 months from the appearance of the first symptoms. Sociodemographic variables, presenting symptoms, knowledge about diseases and its symptoms, time between seeking medical attention after appearance of symptoms and causes of delayed presentation were investigated. Chi-squared and logistic regression tests for significance and associations were used.
Among 125 women with breast cancer fulfilling the inclusion criteria, aged 24-75 years, 88.8% (n=111) presented late (≥3 months) and 59% presented with advanced stage of disease (stage III/IV). The majority (65.6%) were older than 40 years of age, 99.2% were married, 60.8% had <8 years of education, 67.2% had poor social status, and 64.8% had a negative family history of any cancer type. Almost all patients (96%) complained about the presence of a painless lump in their breast. Ignorance of disease or the presence of painless lumps in the breast and low financial resources for therapy (81.1%) were the main variables associated with delayed presentation. Educational factors (<0.001, OR 4.682) and social status (<0.001, OR 1.8) were also associated with delayed presentation.
Our study highlighted the variables associated with delayed presentation in Pakistani breast cancer patients. A significant number of patients presented late owing to misconceptions and poor knowledge about the disease and its symptoms, while illiteracy and poor social status were the major contributing factors for delayed presentation, resulting in an advanced presentation of disease and ultimately a decreased survival rate.
乳腺癌患者延迟寻求医疗护理与就诊时疾病分期较晚及生存率低相关。本研究旨在确定延迟就诊的原因及其与各种社会人口统计学变量的关联。
连续邀请了总共200名有异常临床发现（即肿块或可触及肿物）的女性患者参与本研究。诊断延迟定义为从首次出现症状起超过3个月才咨询医疗服务提供者。调查了社会人口统计学变量、出现的症状、对疾病及其症状的了解、出现症状后寻求医疗关注的时间以及延迟就诊的原因。使用卡方检验和逻辑回归检验来分析显著性和关联性。
在符合纳入标准的125名年龄在24至75岁的乳腺癌女性患者中，88.8%（n = 111）就诊延迟（≥3个月），59%就诊时处于疾病晚期（III/IV期）。大多数（65.6%）年龄超过40岁，99.2%已婚，60.8%受教育年限<8年，67.2%社会地位较低，64.8%无任何癌症类型的家族病史。几乎所有患者（96%）都抱怨乳房有无痛肿块。对疾病的无知、乳房存在无痛肿块以及治疗资金不足（81.1%）是与延迟就诊相关的主要变量。教育因素（<0.001，OR 4.682）和社会地位（<0.001，OR 1.8）也与延迟就诊相关。
我们的研究突出了与巴基斯坦乳腺癌患者延迟就诊相关的变量。相当数量的患者因对疾病及其症状存在误解和了解不足而就诊延迟，而文盲和社会地位低是延迟就诊的主要促成因素，导致疾病就诊时处于晚期，最终生存率降低。
