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. 2015 Feb;25(1):9-14.
doi: 10.1093/eurpub/cku086. Epub 2014 Aug 5.

Factors affecting breast cancer treatment delay in Turkey: a study from Turkish Federation of Breast Diseases Societies

Vahit Ozmen  1 , Sukru Boylu  2 , Engin Ok  3 , Nuh Zafer Canturk  4 , Varol Celik  5 , Murat Kapkac  6 , Sadullah Girgin  7 , Mustafa Tireli  8 , Enver Ihtiyar  9 , Orhan Demircan  10 , Mazhar Semih Baskan  11 , Ayhan Koyuncu  12 , Ismet Tasdelen  13 , Esra Dumanli  14 , Fatih Ozdener  14 , Piotr Zaborek  15
Affiliations

Factors affecting breast cancer treatment delay in Turkey: a study from Turkish Federation of Breast Diseases Societies

Vahit Ozmen et al. Eur J Public Health. 2015 Feb.

Abstract

Background: One of the most important factors in breast cancer (BC) mortality is treatment delay. The primary goal of this survey was to identify factors affecting the total delay time (TDT) in Turkish BC patients.

Methods: A total of 1031 patients with BC were surveyed using a uniform questionnaire. The time between discovering the first symptom and signing up for the first medical visit (patient delay time; PDT) and the time between the first medical visit and the start of therapy (system delay time; SDT) were modelled separately with multilevel regression.

Results: The mean PDT, SDT and TDT were 4.8, 10.5 and 13.8 weeks, respectively. In all, 42% of the patients had a TDT >12 weeks. Longer PDT was significantly correlated with disregarding symptoms and having age of between 30 and 39 years. Shorter PDT was characteristic of patients who: had stronger self-examination habits, received more support from family and friends and had at least secondary education. Predictors of longer SDT included disregard of symptoms, distrust in success of therapy and medical system and having PDT in excess of 4 weeks. Shorter SDT was linked to the age of >60 years. Patients who were diagnosed during a periodic check-up or opportunistic mammography displayed shorter SDT compared with those who had symptomatic BC and their first medical examination was by a surgeon.

Conclusion: TDT in Turkey is long and remains a major problem. Delays can be reduced by increasing BC awareness, implementing organized population-based screening programmes and founding cancer centres.

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Figures

Figure 1
Figure 1
Frequency distributions of PDT, SDT and TDT for BC in Turkey. PDT: Patient delay time in weeks between discovering the first symptom by the patient and registering for the first medical examination. SDT: System delay time in weeks between registering for the first medical examination by the patient and the start of BC treatment. TDT: Total delay time in weeks between discovering the first symptom by the patient and start of therapy calculated as the sum of PDT and SDT
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