An assessment of delays in obtaining definitive breast cancer treatment in southern italy
An assessment of delays in obtaining definitive breast cancer treatment in southern italy
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DOI：
10.1023/a:1010622909643
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发表时间：
2001-04-01
影响因子：
3.8
通讯作者：
D'Aiuto, G
中科院分区：
文献类型：
--
作者：
Montella, M;Crispo, A;D'Aiuto, G
意大利南部女性人口的医疗服务不足（与意大利其他地区相比）。最近对已发表研究进行的系统回顾表明，症状出现和治疗之间延迟 3-6 个月显然与乳腺癌患者较低的生存率相关。本研究的目的是检查意大利南部医疗服务不足的患者的乳腺癌延迟情况，以认识其决定因素，从而为女性提供更好的生存机会。根据 pTNM 系统，检查的变量包括年龄、教育程度、首次出现症状时的症状状态（有症状和无症状）、首次出现症状的日期、首次咨询医疗服务提供者的日期、咨询的提供者、肿瘤大小和淋巴结状态。时间间隔分为：<1个月、1-3个月和>3个月（患者和医疗延误）； 1-3个月，3-6个月，> 6个月为整体延误。患者延误与教育有关：就学时间少于或等于 5 年的女性存在较高风险（OR = 3.3，95%，CI 2.0-5.6）。医疗延误被认为与专业人士有关：老年医师（专门研究乳腺癌的肿瘤学家）和其他专家之间存在显着差异（OR 3.5，95％，CI 1.5-8.4）。年龄和症状表现被发现是高危因素。关于肿瘤大小> 2 cm的病例总体延迟的OR值为2.4（95%，CI 1.5-3.7）。总之，我们的研究表明，诊断延迟与医疗服务不足的状况有关，并且可以通过教育年轻和受教育程度较低的女性（如其他研究中建议的那样）以及为医疗专业人士提供培训计划来减少诊断延迟。
Female population is medically underserved in Southern Italy (in comparison with other Italian regions). In a recent systematic review of published studies, delays of 3-6 months between symptom onset and treatment have been clearly associated with lower survival rates for breast cancer patients. The aim of this study was to examine breast cancer delays in medically underserved patients in Southern Italy, in order to recognize their determinating factors so as to provide women with a better opportunity for survival. The variables examined were age, education, symptom status at first presentation: symptomatic and asymptomatic, date of first symptom presentation, date of first consultation with a health provider, consulted provider, tumor size and nodal status, according to the pTNM system. Time intervals were categorized into: < 1 month, 1-3 months and > 3 months for patient and medical delay; 1-3 months, 3-6 months, > 6 months for overall delay. Patient delay was associated with education: a higher risk was found for women with less than or equal to 5 years school attendance (OR = 3.3, 95%, CI 2.0-5.6). Medical delay was seen to be associated with the professional figure: significant differences were found between senologists (oncologist exclusively dedicated to breast cancer) and other specialists (OR 3.5, 95%, CI 1.5-8.4). Age and symptomatic presentation were found to be high risk factors. Concerning tumor size in overall delay in cases > 2 cm had OR values were of 2.4 (95%, CI 1.5-3.7). In conclusion our study suggests that diagnostic delay is associated with medically underserved status and can be reduced by educating younger and less educated women, as suggested in other studies and by providing training programs for members in the medical profession.