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 and Peter D. Baade
Additional contact information
Philippa H. Youl: Cancer Council Queensland, P.O. Box 201, Spring Hill, QLD 4004, Australia
Joanne F. Aitken: Cancer Council Queensland, P.O. Box 201, Spring Hill, QLD 4004, Australia
Gavin Turrell: Institute of Health and Ageing, Australian Catholic University, Fitzroy, VIC 3115, Australia
Suzanne K. Chambers: Cancer Council Queensland, P.O. Box 201, Spring Hill, QLD 4004, Australia
Jeffrey Dunn: Cancer Council Queensland, P.O. Box 201, Spring Hill, QLD 4004, Australia
Christopher Pyke: Mater Medical Centre, 293 Vulture Street, South Brisbane, QLD 4101, Australia
Peter D. Baade: Cancer Council Queensland, P.O. Box 201, Spring Hill, QLD 4004, Australia

IJERPH, 2016, vol. 13, issue 11, 1-20

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 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2016
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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