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首页> 外文期刊>International Journal of Environmental Research and Public Health >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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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

机译：在澳大利亚昆士兰州以3202名妇女为基础的大型人群研究中，农村和弱势群体对乳腺癌诊断间隔的影响

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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.
机译：延迟诊断乳腺癌（BC）可能导致较差的结果。我们在澳大利亚昆士兰州以人口为基础的队列中3202名被确诊为BC的女性队列研究了与诊断间隔相关的因素。访谈确定了检测方法和医疗/程序约会的日期，并从医疗记录中获得了临床信息。从症状的自我识别（症状检测）或乳房X线照片（屏幕检测）到诊断（诊断间隔（DI））计算时间间隔。该队列包括1560名有症状检测的女性和1642名有筛查的BC的女性。如果是土著妇女，经症状检测的妇女发生DI的几率更高，> 60天（OR = 3.12，95％CI = 1.40，6.98）;居住在外部区域（OR = 1.50，95％CI = 1.09，2.06）或偏远地区（OR = 2.46，95％CI = 1.39，4.38）;或出现“非肿块”症状（OR = 1.84，95％CI = 1.43，2.36）。对于通过屏幕检测的BC，土著妇女（OR = 2.36，95％CI = 1.03，5.80）;居住在偏远地区（OR = 2.35，95％CI = 1.24，4.44）;或弱势地区（OR = 1.69，95％CI = 1.17，2.43）并参加了公共筛查机构（OR = 2.10，95％CI = 1.40，3.17）的DI> 30天的可能性更高。我们的研究表明，在农村，处境不利和土著妇女的直接投资方面存在不利条件。难以获得初级保健和诊断服务。需要确定并实施有效且有效的护理模型，以尽量减少可避免的较长诊断间隔。

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