Identifying women at risk of delayed breast cancer diagnosis

Sherri O. Stuver, Junya Zhu, Brett Simchowitz, Michael J. Hassett, Lawrence N. Shulman, Saul N. Weingart

Research output: Contribution to journalArticle

Abstract

Background: Delays in breast cancer diagnosis contribute to increased morbidity and mortality. Factors related to the occurrence of delayed diagnosis have not been well studied. Methods: A retrospective cohort study of 5,464 women newly diagnosed with breast cancer from 1999 through 2006 was conducted at a comprehensive cancer center in Boston. A delayed diagnosis was defined as an interval greater than 90 days between the patient's first breast-related problem that prompted seeking of medical care and the breast cancer diagnosis based on biopsy. Results: 938 (17%) patients had a delayed breast cancer diagnosis. Non-white race or Hispanic ethnicity (adjusted odds ratio [OR] = 1.46, 95% confidence interval [CI] = 1.13-1.90), living more than 26 miles from Boston (OR 1.46, 95% CI = 1.25-1.71), and initial presentation with a lump found by the patient herself (OR = 2.89, 95% CI = 2.36-3.55) or another breast symptom (OR = 0.25, 95% CI = 1.79-2.82) compared to an abnormal mammogram were significantly associated with a delay in diagnosis. In contrast, the odds of a delay were lower for women who were older than 18-39 years of age and for women living with two or more household members (OR = 0.72, 95% CI = 0.59-0.87). The likelihood of experiencing a delayed breast cancer diagnosis increased markedly if a woman had multiple risk factors, with a nearly 12-fold increase among women with five or more risk factors (OR = 11.96, 95% CI = 6.32-22.61). Conclusions: Younger age, minority race, and self-identification of breast symptom affect the likelihood of delayed breast cancer diagnosis. Awareness of these issues could help focus efforts to develop algorithms that identify women at risk for a delay and build programs that facilitate their timely access to care.

Original languageEnglish (US)
Pages (from-to)568-575
Number of pages8
JournalJoint Commission Journal on Quality and Patient Safety
Volume37
Issue number12
StatePublished - Dec 2011
Externally publishedYes

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Odds Ratio
Confidence Intervals
Breast Neoplasms
Breast
Delayed Diagnosis
Hispanic Americans
Cohort Studies
Retrospective Studies
Morbidity
Biopsy
Mortality
Neoplasms

ASJC Scopus subject areas

  • Leadership and Management

Cite this

Stuver, S. O., Zhu, J., Simchowitz, B., Hassett, M. J., Shulman, L. N., & Weingart, S. N. (2011). Identifying women at risk of delayed breast cancer diagnosis. Joint Commission Journal on Quality and Patient Safety, 37(12), 568-575.

Identifying women at risk of delayed breast cancer diagnosis. / Stuver, Sherri O.; Zhu, Junya; Simchowitz, Brett; Hassett, Michael J.; Shulman, Lawrence N.; Weingart, Saul N.

In: Joint Commission Journal on Quality and Patient Safety, Vol. 37, No. 12, 12.2011, p. 568-575.

Research output: Contribution to journalArticle

Stuver, SO, Zhu, J, Simchowitz, B, Hassett, MJ, Shulman, LN & Weingart, SN 2011, 'Identifying women at risk of delayed breast cancer diagnosis', Joint Commission Journal on Quality and Patient Safety, vol. 37, no. 12, pp. 568-575.
Stuver SO, Zhu J, Simchowitz B, Hassett MJ, Shulman LN, Weingart SN. Identifying women at risk of delayed breast cancer diagnosis. Joint Commission Journal on Quality and Patient Safety. 2011 Dec;37(12):568-575.
Stuver, Sherri O. ; Zhu, Junya ; Simchowitz, Brett ; Hassett, Michael J. ; Shulman, Lawrence N. ; Weingart, Saul N. / Identifying women at risk of delayed breast cancer diagnosis. In: Joint Commission Journal on Quality and Patient Safety. 2011 ; Vol. 37, No. 12. pp. 568-575.
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