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

Youl, Philippa H., Aitken, Joanne F., Turrell, Gavin, Chambers, Suzanne K., Dunn, Jeffrey, Pyke, Christopher and Baade, Peter D. (2016) 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. International Journal of Environmental Research and Public Health, 13 11: . doi:10.3390/ijerph13111156


Author Youl, Philippa H.
Aitken, Joanne F.
Turrell, Gavin
Chambers, Suzanne K.
Dunn, Jeffrey
Pyke, Christopher
Baade, Peter D.
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
Journal name International Journal of Environmental Research and Public Health   Check publisher's open access policy
ISSN 1660-4601
1661-7827
Publication date 2016-11-01
Sub-type Article (original research)
DOI 10.3390/ijerph13111156
Open Access Status DOI
Volume 13
Issue 11
Total pages 20
Place of publication Basel, Switzerland
Publisher M D P I AG
Collection year 2017
Language eng
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.
Keyword Breast cancer
Delay
Diagnosis
Rurality
Inequalities
Health system
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes PMCID:27869758 Mater UQ affiliated: Pyke

 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 1 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 1 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Thu, 01 Dec 2016, 22:14:40 EST by Julia McCabe on behalf of Learning and Research Services (UQ Library)