Factors associated with diagnostic and pre-treatment intervals among breast cancer patients attending care at the Uganda Cancer Institute: A cross-sectional study.
Factors associated with diagnostic and pre-treatment intervals among breast cancer patients attending care at the Uganda Cancer Institute: A cross-sectional study.
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乌干达的大多数乳腺癌 (BC) 患者被诊断为晚期疾病，且预后不佳。本研究调查了在乌干达癌症研究所 (UCI) 接受护理的 BC 患者的诊断和治疗前间隔以及与这些间隔相关的因素。这是一项基于设施的横断面研究。使用由训练有素的研究助理管理的结构化问卷收集数据，并使用 STATA 14.0 版进行分析。改进的泊松回归模型用于确定自变量与诊断和治疗前间隔之间的关联强度。 401 名参与者的平均年龄 (±SD) 为 47.1±11.7 岁。每 10 名参与者中有 4 名患有 III 期癌症 (41.9%；n = 168)，超过三分之一 (34.7%；n = 140) 患有 IV 期癌症。从首次咨询到诊断的中位间隔，即诊断间隔（DI）为5.6个月（IQR：1.5-17.0），而从组织学诊断到开始化疗的中位间隔，即治疗前间隔（PTI）为1.7个月（IQR：0.7-4.5）。大多数（85%，n = 341）参与者在首次咨询临床医生后≥3个月时被诊断出来。接受过高等教育的参与者和居住在距 UCI 100-199 公里范围内的参与者被早期诊断的可能性分别高出四倍和两倍（DI < 首次咨询后 3 个月）（[aPR = 3.88；95% CI：1.15-13.0] 和 [aPR = 2.19；95% CI： 1.06–4.55]），分别。大约一半（48.3%；n=176）的参与者在癌症诊断后 1 个月内开始化疗。居住距离 UCI 超过 300 公里的患者在癌症组织学诊断后 1 个月内开始化疗的可能性较小。 [首次在线发布后于 2023 年 10 月 17 日添加更正。术语“，即”已包含在本版本的结果部分中。] 大多数乳腺癌患者在诊断时已处于晚期。有必要通过确定导致乳腺癌患者诊断间隔延长的因素，促进在癌症仍处于早期阶段时及时诊断的所有努力。
Most breast cancer (BC) patients in Uganda are diagnosed with advanced‐stage disease and experience poor outcomes. This study examined the diagnostic and pre‐treatment intervals and factors associated with these intervals among BC patients attending care at the Uganda Cancer Institute (UCI). This was a cross‐sectional, facility‐based study. Data were collected using structured questionnaire administered by trained research assistants and analyzed using STATA version 14.0. Modified Poisson regressions models were used to determine the strength of associations between independent variables and diagnostic and pre‐treatment intervals. The mean age (±SD) of the 401 participants was 47.1 ± 11.7 years. Four in 10 participants had stage III (41.9%; n = 168) and over a third (34.7%; n = 140) stage IV cancers. The median interval from first consultation to diagnosis, i.e. diagnostic interval (DI) was 5.6 months (IQR: 1.5–17.0), while the median interval from histological diagnosis to start of chemotherapy, i.e. pre‐treatment interval (PTI) was 1.7 months (IQR: 0.7–4.5). Majority (85%, n = 341) of participants were diagnosed at ≥3 months from first consultation with clinicians. Participants with tertiary education and those who lived within 100–199 km from the UCI were about four times and twice more likely to be diagnosed early (DI <3 months from first consultation) ([aPR = 3.88; 95% CI: 1.15–13.0] and [aPR = 2.19; 95% CI: 1.06–4.55]), respectively. About half (48.3%; n = 176) of participants started chemotherapy within 1 month of cancer diagnosis. Patients who lived more than 300 km from the UCI were less likely to start chemotherapy within 1 month of histology diagnosis of cancer. [Correction added on October 17, 2023 after first online publication. The term ‘, i.e.‘ has been included in the results section in this version.] Majority of breast cancer patients are diagnosed late and in advanced stages. There is need to promote all efforts toward timely diagnosis when cancers are still in early stages by identifying factors responsible for prolonged diagnostic intervals among breast cancer patients.
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