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 article
Youl, Philippa H., Aitken, Joanne F., Turrell, Gavin, Chambers, Suzanne K., Dunn, Jeffery, 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), pp. 1 - 20. https://doi.org/10.3390/ijerph13111156
Authors | Youl, Philippa H., Aitken, Joanne F., Turrell, Gavin, Chambers, Suzanne K., Dunn, Jeffery, Pyke, Christopher and Baade, Peter D. |
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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 |
Keywords | breast cancer; delay; diagnosis; rurality; inequalities; health system |
Year | 2016 |
Journal | International Journal of Environmental Research and Public Health |
Journal citation | 13 (11), pp. 1 - 20 |
Publisher | MDPI AG |
ISSN | 1661-7827 |
Digital Object Identifier (DOI) | https://doi.org/10.3390/ijerph13111156 |
Scopus EID | 2-s2.0-84996553618 |
Open access | Open access |
Page range | 1 - 20 |
Research Group | Institute for Health and Ageing |
Publisher's version | License |
Place of publication | Switzerland |
https://acuresearchbank.acu.edu.au/item/86yvy/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
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