Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia.
Global Health Working Group, Martin-Luther-University, Halle-Wittenberg Halle, Germany.
JCO Glob Oncol. 2023 Sep;9:e2300148. doi: 10.1200/GO.23.00148.
There are limited data on the association between delay in breast cancer diagnosis after breast symptom recognition and survival, particularly in sub-Saharan Africa. The recently launched Global Breast Cancer Initiative by WHO includes measuring delay as the core indicator for quality of breast cancer care. Herein, we examined the association between delay in breast cancer diagnosis with overall survival among women in Addis Ababa, Ethiopia.
A total of 439 women diagnosed with breast cancer from January 1, 2017, to June 30, 2018, in Addis Ababa were followed for survival to the end of 2019. Survival rates were estimated using the Kaplan-Meier method. The association between delay in diagnosis (>3 months after symptom recognition) and overall survival was computed using the multivariable Cox regression model after adjusting for demographic and clinical factors.
Nearly 70% (303/439) of women with breast cancer were delayed in diagnosis of their cancer. During a median follow-up period of 25.1 months, 2-year overall survival rate was 73.5% (95% CI, 68.0 to 78.2) in women with diagnosis delay compared with 79.1% (95% CI, 71.2 to 85.1) in those women without diagnosis delay. In the multivariable Cox regression model, the risk of death was 73% higher (hazard ratio, 1.73; 95% CI, 1.09 to 2.74) in women with diagnosis delay compared with those without diagnosis delay.
Delay in diagnostic confirmation of breast cancer after recognition of breast symptoms was negatively associated with overall survival in Addis Ababa, Ethiopia, underscoring the need to increase awareness about the importance of prompt presentation for clinical evaluation and referral for diagnostic confirmation to mitigate the undue high burden of the disease.
在撒哈拉以南非洲地区，有关乳腺癌症状识别后诊断延迟与生存的相关性的数据有限。世界卫生组织（WHO）最近启动的全球乳腺癌倡议将测量延迟作为乳腺癌护理质量的核心指标。在此，我们检查了在埃塞俄比亚亚的斯亚贝巴，乳腺癌诊断延迟与女性总体生存率之间的关联。
共有 439 名女性于 2017 年 1 月 1 日至 2018 年 6 月 30 日在亚的斯亚贝巴被诊断患有乳腺癌，随访至 2019 年底。使用 Kaplan-Meier 方法估计生存率。在调整人口统计学和临床因素后，使用多变量 Cox 回归模型计算诊断延迟（症状识别后>3 个月）与总体生存率之间的关联。
近 70%（303/439）的乳腺癌女性诊断延迟。在中位随访 25.1 个月期间，诊断延迟的女性 2 年总生存率为 73.5%（95%CI，68.0 至 78.2），而无诊断延迟的女性为 79.1%（95%CI，71.2 至 85.1）。在多变量 Cox 回归模型中，与无诊断延迟的女性相比，诊断延迟的女性死亡风险高 73%（危险比，1.73；95%CI，1.09 至 2.74）。
在埃塞俄比亚亚的斯亚贝巴，乳腺癌症状识别后诊断延迟与总体生存率呈负相关，这突显出需要提高对及时就诊进行临床评估和转诊以进行诊断确认的重要性，以减轻疾病的不必要高负担。
