Programa de Pós-graduação em Saúde Coletiva, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, Brasil.
Escola Superior de Ciências da Saúde, Brasília, Brasil.
Cad Saude Publica. 2020 Jan 31;36(2):e00011919. doi: 10.1590/0102-311X00011919. eCollection 2020.
Women presenting with advanced breast cancer tumors are common in Brazil. Little is known about factors contributing to the delay in seeking care. The aim of this study was to identify factors associated with longer time intervals between the onset of breast cancer symptoms and the first medical visit in the Federal District, Brazil. The analysis included 444 symptomatic women with incident breast cancer, interviewed between September, 2012 and September, 2014, during their admission for breast cancer treatment in nine public hospitals in the Federal District. Patients with metastatic disease at diagnosis were not included in this study. The outcome was time interval between symptom onset and the first medical visit, whether > 90 (34% of patients) or ≤ 90 days. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI). In the multivariate analysis, the > 90 day interval was significantly associated with patients not performing mammography and/or breast ultrasound in the two years prior to breast cancer diagnosis (OR = 1.97; 95%CI: 1.26-3.08), and with more advanced stages (OR = 1.72; 95%CI: 1.10-2.72). Furthermore, there was a lower chance of delay in patients with higher levels of education (OR = 0.95; 95%CI: 0.91-0.99). A relatively high proportion of breast cancer patients in the Brazilian Federal District experienced delay to attend the first medical consultation after the symptoms onset. Increasing breast cancer awareness, especially among women with low educational levels and those not participating in mammography screening programs could contribute to reduce this delay.
在巴西，患有晚期乳腺癌肿瘤的女性很常见。对于导致寻求治疗延误的因素知之甚少。本研究旨在确定与巴西联邦区乳腺癌症状出现与首次就诊之间时间间隔较长相关的因素。该分析包括在 2012 年 9 月至 2014 年 9 月期间，因乳腺癌在联邦区九家公立医院接受治疗时接受采访的 444 名有症状的乳腺癌患者。本研究不包括诊断时患有转移性疾病的患者。结果是症状出现与首次就诊之间的时间间隔，是否大于 90 天（34%的患者）或小于等于 90 天。使用逻辑回归估计优势比（OR）和 95%置信区间（95%CI）。在多变量分析中，大于 90 天的间隔与患者在乳腺癌诊断前两年未进行乳房 X 线摄影和/或乳房超声检查（OR=1.97；95%CI：1.26-3.08）显著相关，并且与更晚期的阶段相关（OR=1.72；95%CI：1.10-2.72）。此外，教育程度较高的患者延迟就诊的机会较低（OR=0.95；95%CI：0.91-0.99）。巴西联邦区相当一部分乳腺癌患者在出现症状后延迟首次就诊。提高乳腺癌意识，特别是在教育程度较低和不参加乳房 X 线筛查计划的妇女中，可以有助于减少这种延误。
