internal-medicine-breast-pathology-2018-posters

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Page 68
alliedacademies
Archives of General Internal Medicine | Volume 2
&
April 04-05, 2018 | Miami, USA
International Conference on
Internal Medicine & Practice and Primary Care
International Meeting on
Breast Pathology & Cancer Diagnosis
Background & Aim: One of the most important reasons
of BC mortality is delay in treatment. Due to lack of BC
awareness and organized screening programs, total delay
time (from first symptoms of BC to initiation of treatment;
TDT) is longer in low-middle income countries. The primary
goal of this survey was to identify factors affecting TDT in
patients with BC.
Methods: As a part of previously presented multinational
survey, a total of 1.031 BC patients from 12 cities of 5 districts
in Turkey were surveyed using a uniform questionnaire. TDT
was determined using 8 individual scales, including one
pertaining to patient delay and 7 related to subsequent
steps in a typical diagnostic process. Regression models were
constructed using 17 variables concerning diverse contextual
and personal patient characteristics. Time between first
symptom and first medical visit (Patient Delay Time; PDT)
and time between first medical visit and start of therapy
(System Delay Time; SDT) were modeled separately with
multilevel regression.
Results: Mean PDT, SDT and TDT were 4.8, 10.5 and 13.8
weeks respectively, with 42% of the patients with a delay
of >12 weeks. Multilevel regression equation indicated
that disregard of discovered symptoms (p<0.001) and
having at least secondary level of education (p=0.021)
were significantly correlated with longer PDT. Patients
with stronger self examination habits (p=0.009), reporting
more support from friends and family (p<0.001) and living
in metropolitan areas (>500k) (p=0.006) had shorter PDT.
Predictors of longer SDT included disregard (p<0.001) and
having a PDT>4 weeks (p<0.001). Shorter SDT was correlated
to being older than 60 years of age (p=0.027). Results revealed
that diagnosis during periodic check-up or opportunistic
mammography vs. symptomatic BC (p<0.001) and having first
medical examination by a surgeon resulted in shorter SDT.
Conclusions: TDT in Turkey is unacceptably long and system
delay accounted for a substantial part of the total delay
experienced by breast cancer patients. This points to a need
for shortening clinical pathways if possible. A long patient
delay calls for research into patient awareness of BC.
e:
Factors affecting breast cancer (BC) treatment delay in Turkey
Vahit Ozmen
University of Istanbul, Turkey