The role of health system factors in delaying final diagnosis and treatment of breast cancer in Mexico City, Mexico
The role of health system factors in delaying final diagnosis and treatment of breast cancer in Mexico City, Mexico
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DOI：
10.1016/j.breast.2011.02.012
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发表时间：
2011-04-01
期刊：
影响因子：
3.9
通讯作者：
Formenti, Silvia C.
中科院分区：
文献类型：
--
作者：
Bright, Kristin;Barghash, Maya;Formenti, Silvia C.
在墨西哥，乳腺癌是女性癌症相关死亡的主要原因，大多数病例确诊时已处于晚期（50-60%）。我们假设卫生系统因素可能是造成这种延误的部分原因，并对墨西哥城一家主要公立医院的 166 例新乳腺病例进行了前瞻性审查。我们的分析证实了局部晚期和转移性疾病的患病率（47% 的患者）。对 32 名确诊为 I-IIIC 期乳腺癌的女性进行的子集分析发现，从症状出现到首次初级保健咨询 (PCC) 的平均时间间隔为 1.8 个月，从首次 PCC 到确诊的时间间隔为 6.6 个月，从诊断到开始治疗的时间间隔为 0.6 个月。在确诊之前，患者平均接受了 7.9 次就诊。研究结果表明，从初级护理到专科护理的转诊时间延长是造成延误的主要原因，早期患者的延误时间更长。这些发现表明迫切需要进一步研究和探索干预措施。 (C) 2011 Elsevier Ltd. 保留所有权利。
In Mexico, breast cancer is the leading cancer-related death among women and most cases are diagnosed at advanced stages (50-60%). We hypothesized health system factors could be partly responsible for this delay and performed a prospective review of 166 new breast cases at a major public hospital in Mexico City. Our analysis confirmed the prevalence of locally advanced and metastatic disease (47% of patients). A subset analysis of 32 women with confirmed stage I-IIIC breast cancer found an average time interval of 1.8 months from symptom onset to first primary care consultation (PCC), with an additional 6.6 months from first PCC to confirmed diagnosis, and 0.6 months from diagnosis to treatment initiation. Patients underwent an average of 7.9 clinic visits before confirmed diagnosis. Findings suggest that protracted referral time from primary to specialty care accounts for the bulk of delay, with earlier stage patients experiencing longer delays. These findings reveal a critical need for further study and exploration of interventions. (C) 2011 Elsevier Ltd. All rights reserved.