Factors associated with time to first healthcare visit, diagnosis and treatment, and their impact on survival among breast cancer patients in Mali.
Factors associated with time to first healthcare visit, diagnosis and treatment, and their impact on survival among breast cancer patients in Mali.
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DOI：
10.1371/journal.pone.0207928
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Kantelhardt EJ
中科院分区：
文献类型：
--
作者：
Grosse Frie K;Kamaté B;Traoré CB;Ly M;Mallé B;Coulibaly B;Wienke A;Kantelhardt EJ
分析影响撒哈拉以南非洲地区乳腺癌患者首次就诊、诊断和治疗时间的患者和医疗保健系统相关因素，以及对生存率的影响，以便为早期检测策略提供建议。在巴马科大学医院的马里唯一病理科进行了一项前瞻性医院队列研究。所有在2016年1月至4月期间诊断为乳腺癌的女性患者均接受了结构化问卷（N = 64）采访，以收集有关乳腺症状识别和首次医疗保健访视的信息。在18个月随访时收集关于治疗开始和生存率的信息。进行简单的考克斯回归分析。至首次医疗访视的中位时间为4.8个月，从首次医疗访视至诊断的时间为0.9个月，对于开始治疗的患者（N = 46），从诊断至治疗的时间为1.3个月。了解乳房自我检查和正确的症状解释增加了早期医疗保健访问的机会。与家庭主妇相比，工作妇女和生活在巴马科的妇女的诊断时间较长，首次就诊时间较短。生活在巴马科以外和较小的肿瘤大小（T1/T2）延长了治疗时间。传统治疗者和较大肿瘤大小（T3/T4）的访问缩短了生存时间，而首次医疗保健访问的时间和随后的诊断时间对生存没有影响。只有当大多数患者都需要连续的乳腺癌护理时，分期下调策略才有用。
To analyse patient and healthcare system related factors influencing the time to first healthcare visit, diagnosis and treatment of breast cancer patients in sub-Saharan Africa and the impact on survival in order to advise on early detection strategies. A prospective hospital cohort study was conducted at the only pathology department in Mali, at the University Hospital in Bamako. All the female patients with a breast cancer diagnosis between January and April 2016 were interviewed with a structured questionnaire (N = 64) to gather information about breast symptom recognition and first healthcare visit. Information on beginning of treatment and survival were collected at 18-months follow-up. Simple Cox regression analyses were performed. The median time to first healthcare visit was 4.8 months, from first healthcare visit to diagnosis was 0.9 months and for the patients who started treatment (N = 46) the time from diagnosis to treatment was 1.3 months. Knowledge of breast-self-examination and correct symptom interpretation increased the chance of an earlier healthcare visit. Prolonged time to diagnosis was found with shorter duration to first healthcare visit, for working women compared to housewives and for those living within Bamako. Living outside Bamako and smaller tumour size (T1/T2) prolonged time to treatment. Visit of a traditional healer and larger tumour size (T3/T4) shortened survival time, whereas time to first healthcare visit and subsequent time to diagnosis had no influence on survival. Down-staging strategies are only useful if the continuum of breast cancer care is warranted for the majority of patients.
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影响因子：
1.8
作者：
Odongo, J;Makumbi, T;Galukande, M
通讯作者：
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影响因子：
3.9
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Adesunkanmi, A. R. K.;Lawal, O. O.;Durosimi, M. A.
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Durosimi, M. A.
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作者：
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2.1
作者：
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Badran, Atef