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

Philippa H. Youl, Joanne F. Aitken, Gavin Turrell, Suzanne K. Chambers, Jeffrey Dunn, Christopher Pyke, Peter D. Baade

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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.

Original languageEnglish
Article number1156
Pages (from-to)1-20
Number of pages20
JournalInternational Journal of Environmental Research and Public Health
Volume13
Issue number11
DOIs
Publication statusPublished - 19 Nov 2016
Externally publishedYes

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Queensland
Breast Neoplasms
Population
Vulnerable Populations
Public Facilities
Diagnostic Services
Medical Records
Primary Health Care
Appointments and Schedules
Interviews

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Youl, Philippa H. ; Aitken, Joanne F. ; Turrell, Gavin ; Chambers, Suzanne K. ; Dunn, Jeffrey ; Pyke, Christopher ; Baade, Peter D. / 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. In: International Journal of Environmental Research and Public Health. 2016 ; Vol. 13, No. 11. pp. 1-20.
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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.",
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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. / Youl, Philippa H.; Aitken, Joanne F.; Turrell, Gavin; Chambers, Suzanne K.; Dunn, Jeffrey; Pyke, Christopher; Baade, Peter D.

In: International Journal of Environmental Research and Public Health, Vol. 13, No. 11, 1156, 19.11.2016, p. 1-20.

Research output: Contribution to journalArticleResearchpeer-review

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