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Factors related to breast cancer detection mode and time to diagnosis in Alberta, Canada: a population-based retrospective cohort study.

Yuan Y, Li M, Yang J, Elliot T, Dabbs K, Dickinson JA, Fisher S, Winget M - BMC Health Serv Res (2016)

Bottom Line: Understanding the factors affecting the mode and timeliness of breast cancer diagnosis is important to optimizing patient experiences and outcomes.Screen-detected patients were identified as having a screening mammogram within 6-months prior to diagnosis; remaining patients were considered symptom-detected.The variation by health region, however, was large ranging from an estimated median of 4 to 37 days for screen-detected patients and from 17 to 33 days for symptom-detected patients.

View Article: PubMed Central - PubMed

Affiliation: School of Public Health, University of Alberta, Edmonton, Alberta, T6G 1C9, Canada. yyuan@ualberta.ca.

ABSTRACT

Background: Understanding the factors affecting the mode and timeliness of breast cancer diagnosis is important to optimizing patient experiences and outcomes. The purposes of the study were to identify factors related to the length of the diagnostic interval and assess how they vary by mode of diagnosis: screen or symptom detection.

Methods: All female residents of Alberta diagnosed with first primary breast cancer in years 2004-2010 were identified from the Alberta Cancer Registry. Data were linked to Physician Claims and screening program databases. Screen-detected patients were identified as having a screening mammogram within 6-months prior to diagnosis; remaining patients were considered symptom-detected. Separate quantile regression was conducted for each detection mode to assess the relationship between demographic/clinical and healthcare factors.

Results: Overall, 38 % of the 12,373 breast cancer cases were screen-detected compared to 47 % of the screen-eligible population. Health region of residence was strongly associated with cancer detection mode. The median diagnostic interval for screen and symptom-detected cancers was 19 and 21 days, respectively. The variation by health region, however, was large ranging from an estimated median of 4 to 37 days for screen-detected patients and from 17 to 33 days for symptom-detected patients. Cancer stage was inversely associated with the diagnostic interval for symptom-detected cancers, but not for screen-detected cancers.

Conclusion: Significant variation by health region in both the percentage of women with screen-detected cancer and the length of the diagnostic interval for screen and symptom-detected breast cancers suggests there could be important differences in local breast cancer diagnostic care coordination.

No MeSH data available.


Related in: MedlinePlus

An illustration of the effect modification on percent screening-detection. The percent screening detected female breast cancers in different RHAs was modified by the time period in women diagnosed in Alberta, Canada in years 2004–2010
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Fig4: An illustration of the effect modification on percent screening-detection. The percent screening detected female breast cancers in different RHAs was modified by the time period in women diagnosed in Alberta, Canada in years 2004–2010

Mentions: Figure 4 shows significant interaction between RHA and time period. The probability of screen-detected cancer increased in all regions from 2004–2006 to 2007–2010, however, it increased to a greater extent in RHAs 2 and 8 than other RHAs (P < 0.001).Fig. 4


Factors related to breast cancer detection mode and time to diagnosis in Alberta, Canada: a population-based retrospective cohort study.

Yuan Y, Li M, Yang J, Elliot T, Dabbs K, Dickinson JA, Fisher S, Winget M - BMC Health Serv Res (2016)

An illustration of the effect modification on percent screening-detection. The percent screening detected female breast cancers in different RHAs was modified by the time period in women diagnosed in Alberta, Canada in years 2004–2010
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4759735&req=5

Fig4: An illustration of the effect modification on percent screening-detection. The percent screening detected female breast cancers in different RHAs was modified by the time period in women diagnosed in Alberta, Canada in years 2004–2010
Mentions: Figure 4 shows significant interaction between RHA and time period. The probability of screen-detected cancer increased in all regions from 2004–2006 to 2007–2010, however, it increased to a greater extent in RHAs 2 and 8 than other RHAs (P < 0.001).Fig. 4

Bottom Line: Understanding the factors affecting the mode and timeliness of breast cancer diagnosis is important to optimizing patient experiences and outcomes.Screen-detected patients were identified as having a screening mammogram within 6-months prior to diagnosis; remaining patients were considered symptom-detected.The variation by health region, however, was large ranging from an estimated median of 4 to 37 days for screen-detected patients and from 17 to 33 days for symptom-detected patients.

View Article: PubMed Central - PubMed

Affiliation: School of Public Health, University of Alberta, Edmonton, Alberta, T6G 1C9, Canada. yyuan@ualberta.ca.

ABSTRACT

Background: Understanding the factors affecting the mode and timeliness of breast cancer diagnosis is important to optimizing patient experiences and outcomes. The purposes of the study were to identify factors related to the length of the diagnostic interval and assess how they vary by mode of diagnosis: screen or symptom detection.

Methods: All female residents of Alberta diagnosed with first primary breast cancer in years 2004-2010 were identified from the Alberta Cancer Registry. Data were linked to Physician Claims and screening program databases. Screen-detected patients were identified as having a screening mammogram within 6-months prior to diagnosis; remaining patients were considered symptom-detected. Separate quantile regression was conducted for each detection mode to assess the relationship between demographic/clinical and healthcare factors.

Results: Overall, 38 % of the 12,373 breast cancer cases were screen-detected compared to 47 % of the screen-eligible population. Health region of residence was strongly associated with cancer detection mode. The median diagnostic interval for screen and symptom-detected cancers was 19 and 21 days, respectively. The variation by health region, however, was large ranging from an estimated median of 4 to 37 days for screen-detected patients and from 17 to 33 days for symptom-detected patients. Cancer stage was inversely associated with the diagnostic interval for symptom-detected cancers, but not for screen-detected cancers.

Conclusion: Significant variation by health region in both the percentage of women with screen-detected cancer and the length of the diagnostic interval for screen and symptom-detected breast cancers suggests there could be important differences in local breast cancer diagnostic care coordination.

No MeSH data available.


Related in: MedlinePlus