Breast cancer diagnosis and staging in Chile: A non-randomized survey-based study to assess frequency and delays
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作者:
Campana, Carla
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机构:
Univ Desarrollo, Fac Med Clin Alemana, Ctr Salud Global Intercultural, Santiago, Chile
Univ Desarrollo, Fac Psicol, Santiago, ChileUniv Desarrollo, Fac Med Clin Alemana, Ctr Salud Global Intercultural, Santiago, Chile
Campana, Carla
[1
,2
]
Oyarte, Marcela
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机构:
Inst Salud Publ Chile, Subdept Innovac & Desarrollo, Santiago, Chile
Inst Salud Publ Chile, Dept Agencia Nacl Disposit Med Innovac & Desarroll, Santiago, ChileUniv Desarrollo, Fac Med Clin Alemana, Ctr Salud Global Intercultural, Santiago, Chile
Oyarte, Marcela
[3
,4
]
Cabieses, Baltica
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机构:
Univ Desarrollo, Fac Med Clin Alemana, Ctr Salud Global Intercultural, Santiago, Chile
Univ Desarrollo, Fac Psicol, Santiago, Chile
Ctr Prevenc & Control Canc, Santiago, ChileUniv Desarrollo, Fac Med Clin Alemana, Ctr Salud Global Intercultural, Santiago, Chile
Cabieses, Baltica
[1
,2
,5
]
Obach, Alexandra
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机构:
Univ Desarrollo, Fac Med Clin Alemana, Ctr Salud Global Intercultural, Santiago, Chile
Univ Desarrollo, Fac Psicol, Santiago, Chile
Ctr Prevenc & Control Canc, Santiago, ChileUniv Desarrollo, Fac Med Clin Alemana, Ctr Salud Global Intercultural, Santiago, Chile
Obach, Alexandra
[1
,2
,5
]
机构:
[1] Univ Desarrollo, Fac Med Clin Alemana, Ctr Salud Global Intercultural, Santiago, Chile
Breast Neoplasms;
diagnosis;
Time-to-Treatment;
Early Detection of Cancer;
social determinants of health;
biopsy;
Health Inequities;
HEALTH;
WOMEN;
D O I:
10.5867/medwave.2024.09.2801
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
INTRODUCTION Breast cancer progression involves physiological mechanisms such as metastasis. Delays in diagnosis and treatment increase the risk of mortality and are associated with barriers to healthcare access. In Chile, breast cancer is highly prevalent, and early diagnosis has improved, although disparities in the disease evolution persist. This study characterized diagnostic and staging tests, waiting times, and sociodemographic profiles to identify delays and inequities in care. METHODS Survey study. Using a non-probabilistic sample, a questionnaire was applied in an encrypted platform with prior informed consent. The instrument collected data on requested tests, associated times, staging, and sociodemographic characteristics. These variables were analyzed using descriptive statistics, tests of association, confidence intervals, and comparison tests using bootstrapping. RESULTS A sample of 263 persons was obtained. The most requested tests were biopsy (99.62%) and blood tests (80.23%). The median number of tests requested was six (Q1:4, Q3:8), with a mean of 5.87 (standard deviation: 2.24). No significant differences were observed in the percentage of persons from whom the total number of examinations were requested according to the studied variables. The day-hour-result intervals ranged from 1 to 365 days. The median day-hour-result of the biopsy was 15 days (Q1:10, Q3:30). People between 40 and 49 years old, non-residents of the capital city, belonging to income quintile I, with high school education, from the public health system, with late-stage diagnosis had higher median day-hour-result in biopsy. There was no significant difference in the number of requested tests according to staging (I and II, or III and IV). CONCLUSIONS Biopsy in Chile is the test of choice for diagnostic confirmation in breast cancer. Other tests are requested regardless of the diagnosis stage, contrary to the recommendations of clinical guidelines. Cancer prognosis is crucial, especially in countries with greater inequalities.
机构:
Boston Univ, Dept Hlth Law Policy & Management, 261 Talbot, Boston, MA 02118 USABoston Univ, Dept Hlth Law Policy & Management, 261 Talbot, Boston, MA 02118 USA
Louis, Christopher J.
Clark, Jonathan R.
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Univ Texas San Antonio, Coll Business, San Antonio, TX USABoston Univ, Dept Hlth Law Policy & Management, 261 Talbot, Boston, MA 02118 USA
Clark, Jonathan R.
Hillemeier, Marianne M.
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Penn State Univ, Dept Hlth Policy & Adm, University Pk, PA 16802 USABoston Univ, Dept Hlth Law Policy & Management, 261 Talbot, Boston, MA 02118 USA
Hillemeier, Marianne M.
Camacho, Fabian
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Univ Virginia, Dept Publ Hlth Sci, Charlottesville, VA USABoston Univ, Dept Hlth Law Policy & Management, 261 Talbot, Boston, MA 02118 USA
Camacho, Fabian
Yao, Nengliang
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Univ Virginia, Dept Publ Hlth Sci, Charlottesville, VA USABoston Univ, Dept Hlth Law Policy & Management, 261 Talbot, Boston, MA 02118 USA
Yao, Nengliang
Anderson, Roger T.
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Univ Virginia, Dept Publ Hlth Sci, Charlottesville, VA USABoston Univ, Dept Hlth Law Policy & Management, 261 Talbot, Boston, MA 02118 USA
机构:
Choonhae Coll Hlth Sci, Dept Nursing, Ulsan, South Korea
Daedong Coll, Dept Nursing, Busan, South KoreaChoonhae Coll Hlth Sci, Dept Nursing, Ulsan, South Korea
机构:
Kaohsiung Chang Gung Mem Hosp, Div Oncol, Dept Internal Med, Kaohsiung 83301, Taiwan
Chang Gung Univ, Coll Med, Kaohsiung 83301, TaiwanKaohsiung Chang Gung Mem Hosp, Div Oncol, Dept Internal Med, Kaohsiung 83301, Taiwan
Liu, Chien-Ting
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Chen, Yen-Hao
Huang, Yu-Chuen
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机构:
China Med Univ, China Med Univ Hosp, Dept Med Res, Taichung 41354, Taiwan
China Med Univ, Sch Chinese Med, Taichung 41354, TaiwanKaohsiung Chang Gung Mem Hosp, Div Oncol, Dept Internal Med, Kaohsiung 83301, Taiwan
Huang, Yu-Chuen
Chen, Shih-Yu
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机构:
E Da Hosp, Dept Pediat, Kaohsiung, Taiwan
I Shou Univ, Kaohsiung, TaiwanKaohsiung Chang Gung Mem Hosp, Div Oncol, Dept Internal Med, Kaohsiung 83301, Taiwan
Chen, Shih-Yu
Tsai, Ming-Yen
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Chang Gung Univ, Chang Gung Mem Hosp, Kaohsiung Med Ctr, Dept Chinese Med,Coll Med, Kaohsiung 83301, TaiwanKaohsiung Chang Gung Mem Hosp, Div Oncol, Dept Internal Med, Kaohsiung 83301, Taiwan