埃塞俄比亚西北部乳腺癌晚期诊断相关因素：一项横断面研究。
Factors associated with advanced-stage diagnosis of breast cancer in north-west Ethiopia: a cross-sectional study.
作者信息
Tesfaw Aragaw, Tiruneh Mulu, Tamire Tadese, Yosef Tewodros
机构信息
Debre Tabor University, College of Health Sciences, Department of Public Health, PO Box 272, Debre Tabor, Ethiopia.
Debre Tabor University, College of Health Sciences, Department of Anesthesia, PO Box 272, Debre Tabor, Ethiopia.
出版信息
Ecancermedicalscience. 2021 Mar 25;15:1214. doi: 10.3332/ecancer.2021.1214. eCollection 2021.
BACKGROUND
Breast cancer tumours are the most common malignant tumours among women in Ethiopia. Although advanced-stage diagnosis of breast cancer is a common problem, evidence-based information is lacking about the magnitude and determinants of advanced-stage presentation in north-west Ethiopia.
METHODS
An institution-based, cross-sectional study was conducted at the oncology units of the University of Gondar and Felege Hiwot specialised hospitals. Stages III and IV were considered advanced stage, whereas stages I and II were considered early stages. Data were collected prospectively on newly diagnosed breast cancer patients and entered using the EPI Info version 7.2 and analysed using Statistical Package for the Social Sciences version 23. Multivariable logistic regression was used to identify the determinants of advanced-stage diagnosis of breast cancer. A -value < 0.05 was used as the cut-off point to select the determinants of the advanced stage.
RESULT
About 71.2% of breast cancer patients presented with advanced-stage disease. The median age of patients was 40 years. Rural residence (adjusted odds ratio (AOR) = 1.7; 95% confidence interval (CI): 1.02, 2.96), painless breast lump/wound (AOR = 2.5; 95% CI: 1.45, 4.13), travel distance ≥5 km (AOR = 3.2; 95% CI: 1.72, 5.29), not practising breast self-examination (BSE) (AOR = 2.9; 95% CI: 1.30, 6.52), time to presentation ≥3 months (AOR = 1.4; 95% CI: 1.02, 2.37) and misdiagnosed at first visit (AOR = 1.9; 95% CI: 1.09, 3.59) were determinants of advanced-stage breast cancer.
CONCLUSION
Nearly three-quarters of the patients were diagnosed with advanced-stage breast cancer. Not practising BSE, travel distance ≥5 km, rural residence, painless breast wound/lump and being misdiagnosed at first visit were important determinants of advanced-stage diagnosis of breast cancer. Focused awareness creation programmes for the public and increasing cancer diagnostic centres in the country are crucial to downstage breast cancer at presentation.
背景
乳腺癌是埃塞俄比亚女性中最常见的恶性肿瘤。尽管乳腺癌晚期诊断是一个常见问题，但埃塞俄比亚西北部关于晚期病例的规模和决定因素缺乏循证信息。
方法
在贡德尔大学和费莱格·希沃特专科医院的肿瘤科开展了一项基于机构的横断面研究。将III期和IV期视为晚期，而I期和II期视为早期。前瞻性收集新诊断乳腺癌患者的数据，使用EPI Info 7.2版本录入，并使用社会科学统计软件包23.0版本进行分析。采用多变量逻辑回归确定乳腺癌晚期诊断的决定因素。以P值<0.05作为选择晚期决定因素的截断点。
结果
约71.2%的乳腺癌患者表现为晚期疾病。患者的中位年龄为40岁。农村居住（调整比值比[AOR]=1.7；95%置信区间[CI]：1.02，2.9）、无痛性乳腺肿块/伤口（AOR=2.5；95%CI：1.45，4.13）、就诊距离≥5公里（AOR=3.2；95%CI：1.72，5.29）、未进行乳房自我检查（BSE）（AOR=2.9；95%CI：1.30，6.52）、就诊时间≥3个月（AOR=1.4；95%CI：1.02，2.37）以及初诊时误诊（AOR=1.9；95%CI：1.09，3.59）是晚期乳腺癌的决定因素。
结论
近四分之三的患者被诊断为晚期乳腺癌。未进行乳房自我检查、就诊距离≥5公里、农村居住、无痛性乳腺伤口/肿块以及初诊时误诊是乳腺癌晚期诊断的重要决定因素。为公众开展有针对性的提高认识项目以及在该国增加癌症诊断中心对于降低乳腺癌就诊时的分期至关重要。
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