Centro de Salud Global Intercultural, Facultad de Medicina-Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
Subdepartamento Innovación y Desarrollo y Departamento Agencia Nacional de Dispositivos Médicos, Innovación y Desarrollo, Instituto de Salud Pública de Chile, Santiago, Chile.
Medwave. 2024 Oct 14;24(9):e2801. doi: 10.5867/medwave.2024.09.2801.
Breast cancer progression involves physiological mechanisms such as metastasis. Delays in diagnosis and treatment increase the risk of mortality and are associated with barriers to healthcare access. In Chile, breast cancer is highly prevalent, and early diagnosis has improved, although disparities in the disease evolution persist. This study characterized diagnostic and staging tests, waiting times, and sociodemographic profiles to identify delays and inequities in care.
Survey study. Using a non-probabilistic sample, a questionnaire was applied in an encrypted platform with prior informed consent. The instrument collected data on requested tests, associated times, staging, and sociodemographic characteristics. These variables were analyzed using descriptive statistics, tests of association, confidence intervals, and comparison tests using bootstrapping.
A sample of 263 persons was obtained. The most requested tests were biopsy (99.62%) and blood tests (80.23%). The median number of tests requested was six (Q1:4, Q3:8), with a mean of 5.87 (standard deviation: 2.24). No significant differences were observed in the percentage of persons from whom the total number of examinations were requested according to the studied variables. The day-hour-result intervals ranged from 1 to 365 days. The median day-hour-result of the biopsy was 15 days (Q1:10, Q3:30). People between 40 and 49 years old, non-residents of the capital city, belonging to income quintile I, with high school education, from the public health system, with late-stage diagnosis had higher median day-hour-result in biopsy. There was no significant difference in the number of requested tests according to staging (I and II, or III and IV).
Biopsy in Chile is the test of choice for diagnostic confirmation in breast cancer. Other tests are requested regardless of the diagnosis stage, contrary to the recommendations of clinical guidelines. Cancer prognosis is crucial, especially in countries with greater inequalities.
乳腺癌的进展涉及到转移等生理机制。诊断和治疗的延误增加了死亡率的风险，并与获得医疗保健的障碍有关。在智利，乳腺癌的发病率很高，早期诊断已经得到改善，尽管疾病发展的差异仍然存在。本研究描述了诊断和分期检查、等待时间和社会人口统计学特征，以确定护理中的延迟和不平等。
调查研究。使用非概率样本，在事先知情同意的加密平台上应用问卷。该工具收集了请求的测试、相关时间、分期和社会人口统计学特征的数据。使用描述性统计、关联检验、置信区间和使用引导的比较检验分析这些变量。
获得了 263 人的样本。最常请求的测试是活检（99.62%）和血液测试（80.23%）。中位数请求的测试数量为 6 个（Q1：4，Q3：8），平均为 5.87（标准差：2.24）。根据所研究的变量，没有观察到请求总检查数量的人的百分比有显著差异。日-小时-结果间隔范围从 1 天到 365 天。活检的中位数日-小时-结果为 15 天（Q1：10，Q3：30）。40 至 49 岁之间的人、非首都居民、属于收入五分位数 I、高中教育、来自公共卫生系统、晚期诊断的人，活检的中位数日-小时-结果更高。根据分期（I 和 II，或 III 和 IV），请求的测试数量没有显著差异。
在智利，活检是乳腺癌诊断确认的首选测试。其他测试是根据临床指南的建议请求的，无论诊断阶段如何。癌症的预后是至关重要的，特别是在不平等程度较高的国家。
