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The Impact of Rurality and Disadvantage on the Diagnostic Interval for Breast Cancer in a Large Population-Based Study of 3202 Women in Queensland, Australia

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Title: The Impact of Rurality and Disadvantage on the Diagnostic Interval for Breast Cancer in a Large Population-Based Study of 3202 Women in Queensland, Australia
Authors: Philippa Youl, Joanne Aitken, Gavin Turrell, Suzanne Chambers, Jeffrey Dunn, Christopher Pyke, Peter Baade
Source: Int J Environ Res Public Health
International Journal of Environmental Research and Public Health; Volume 13; Issue 11; Pages: 1156
Publisher Information: MDPI AG, 2016.
Publication Year: 2016
Subject Terms: Rural Population, Time Factors, diagnosis, analyses, 2739 Public Health, Cohort Studies, Breast cancer, 0302 clinical medicine, Diagnosis, Odds Ratio, health system, Longitudinal Studies, Early Detection of Cancer, or interpretation of data, Delay, Middle Aged, 3. Good health, 2307 Health, Early Detection of Cancer/*statistics & numerical data, Female, Queensland, rurality, Mammography, Healthcare Disparities, Breast Neoplasms/*diagnosis, Adult, Rurality, in the writing of the manuscript, delay, Health services and systems not elsewhere classified, and in the decision to publish the result, Breast Neoplasms, in the collection, Vulnerable Populations, Article, Vulnerable Populations/*statistics & numerical data, Young Adult, 03 medical and health sciences, breast cancer, inequalities, Rural Population/*statistics & numerical data, Health system, Humans, Toxicology and Mutagenesis, the design of the study, Aged, Environmental and Occupational Health, Public health not elsewhere classified, 15. Life on land, Mammography/*statistics & numerical data, FoR multidisciplinary, Socioeconomic Factors, Inequalities
Description: Delays in diagnosing breast cancer (BC) can lead to poorer outcomes. We investigated factors related to the diagnostic interval in a population-based cohort of 3202 women diagnosed with BC in Queensland, Australia. Interviews ascertained method of detection and dates of medical/procedural appointments, and clinical information was obtained from medical records. Time intervals were calculated from self-recognition of symptoms (symptom-detected) or mammogram (screen-detected) to diagnosis (diagnostic interval (DI)). The cohort included 1560 women with symptom-detected and 1642 with screen-detected BC. Symptom-detected women had higher odds of DI of >60 days if they were Indigenous (OR = 3.12, 95% CI = 1.40, 6.98); lived in outer regional (OR = 1.50, 95% CI = 1.09, 2.06) or remote locations (OR = 2.46, 95% CI = 1.39, 4.38); or presented with a “non-lump” symptom (OR = 1.84, 95% CI = 1.43, 2.36). For screen-detected BC, women who were Indigenous (OR = 2.36, 95% CI = 1.03, 5.80); lived in remote locations (OR = 2.35, 95% CI = 1.24, 4.44); or disadvantaged areas (OR = 1.69, 95% CI = 1.17, 2.43) and attended a public screening facility (OR = 2.10, 95% CI = 1.40, 3.17) had higher odds of DI > 30 days. Our study indicates a disadvantage in terms of DI for rural, disadvantaged and Indigenous women. Difficulties in accessing primary care and diagnostic services are evident. There is a need to identify and implement an efficient and effective model of care to minimize avoidable longer diagnostic intervals.
Document Type: Article
Other literature type
File Description: application/pdf
Language: English
ISSN: 1660-4601
DOI: 10.3390/ijerph13111156
Access URL: https://www.mdpi.com/1660-4601/13/11/1156/pdf
https://pubmed.ncbi.nlm.nih.gov/27869758
https://dro.deakin.edu.au/eserv/DU:30117566/turrell-impactofrurality-2019.pdf
https://researchers.cdu.edu.au/en/publications/the-impact-of-rurality-and-disadvantage-on-the-diagnostic-interva
https://eprints.usq.edu.au/32059/
https://www.mdpi.com/1660-4601/13/11/1156/pdf
https://eprints.qut.edu.au/110077/
https://acuresearchbank.acu.edu.au/item/86yvy/the-impact-of-rurality-and-disadvantage-on-the-diagnostic-interval-for-breast-cancer-in-a-large-population-based-study-of-3202-women-in-queensland-australia
https://acuresearchbank.acu.edu.au/item/86yvy/the-impact-of-rurality-and-disadvantage-on-the-diagnostic-interval-for-breast-cancer-in-a-large-population-based-study-of-3202-women-in-queensland-australia
Rights: CC BY
Accession Number: edsair.doi.dedup.....4dbd2e5360f6c5f8ef0b03004a94ed71
Database: OpenAIRE
Description
Abstract:Delays in diagnosing breast cancer (BC) can lead to poorer outcomes. We investigated factors related to the diagnostic interval in a population-based cohort of 3202 women diagnosed with BC in Queensland, Australia. Interviews ascertained method of detection and dates of medical/procedural appointments, and clinical information was obtained from medical records. Time intervals were calculated from self-recognition of symptoms (symptom-detected) or mammogram (screen-detected) to diagnosis (diagnostic interval (DI)). The cohort included 1560 women with symptom-detected and 1642 with screen-detected BC. Symptom-detected women had higher odds of DI of >60 days if they were Indigenous (OR = 3.12, 95% CI = 1.40, 6.98); lived in outer regional (OR = 1.50, 95% CI = 1.09, 2.06) or remote locations (OR = 2.46, 95% CI = 1.39, 4.38); or presented with a “non-lump” symptom (OR = 1.84, 95% CI = 1.43, 2.36). For screen-detected BC, women who were Indigenous (OR = 2.36, 95% CI = 1.03, 5.80); lived in remote locations (OR = 2.35, 95% CI = 1.24, 4.44); or disadvantaged areas (OR = 1.69, 95% CI = 1.17, 2.43) and attended a public screening facility (OR = 2.10, 95% CI = 1.40, 3.17) had higher odds of DI > 30 days. Our study indicates a disadvantage in terms of DI for rural, disadvantaged and Indigenous women. Difficulties in accessing primary care and diagnostic services are evident. There is a need to identify and implement an efficient and effective model of care to minimize avoidable longer diagnostic intervals.
ISSN:16604601
DOI:10.3390/ijerph13111156