1393P - Factors influencing time to seeking medical advice and treatment onset in breast cancer patients in Serbia

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Bioethics, Legal, and Economic Issues
Breast Cancer
Presenter Ljiljana Stamatovic
Citation Annals of Oncology (2014) 25 (suppl_4): iv486-iv493. 10.1093/annonc/mdu353
Authors L. Stamatovic1, S.D. Mamula Masic2, D. Vukotic3, Z. Kovac4, Z. Mihailovic5, K. Zdravkovic6, D. Petkovic7, T. Bagi8, N. Milic9
  • 1Medical Oncology, Institute of Oncology and Radiology of Serbia, 11000 - Belgrade/YU
  • 2Medical, Roche d.o.o., 11080 - New Belgrade/YU
  • 3Oncology Surgery, Institute for Oncolology and Radiology of Serbia, Belgrade/YU
  • 4Oncology Clinic For Radiology And Diagnostics, Institute for Oncology and Radiology of Serbia, Belgrade/YU
  • 5Oncology, General Hospital Loznica, 15300 - Loznica/YU
  • 6Internal Medicine, General Hospital Vranje, 17500 - Vranje/YU
  • 7Polyclinic, Oncology Institute of Vojvodina, 21204 - Sremska Kamenica/YU
  • 8Oncology, General Hospital Subotica, Subotica/YU
  • 9Statistics And Informatics, Institute for Medical Statistics and Informatics, Medical Faculty University of Belgrade, 11000 - Belgrade/YU

Abstract

Aim

Cancer suffering patients often delay going to the doctor, leading to the extension of the time elapsed from onset of symptoms to treatment of disease (total delay time; TDT), which can have a negative impact on disease progression and treatment outcomes. The aim of this study was to determine factors affecting two individual segments of TDT: time from the onset of symptoms to seeking medical advice (patient delay time; PDT) and time of first contact with the doctor to starting treatment (system delay time; SDT).

Methods

800 breast cancer patients from 10 centers residing in Serbia were investigated using a uniform questionnaire. TDT was determined using the 8 individual scales, including one referring to patient -related factors, and 7 related to subsequent steps in a typical diagnostic process, i.e. health system related factors. Regression models were performed using the variables from the questionnaire relating to the different personal characteristics and environmental features related to patients.

Results

Mean PDT, SDT and TDT were 4.5, 9.2 and 12.9 weeks; 20 % of patients had PDT >12 weeks. In a multivariate regression model longer PDT and SDT were associated with distrust in the health care system and treatment success, lack of time to go to the doctor, and refusing to recognize the severity of the disease (p < 0.05). The shorter PDT was observed in patients who performed self-exams, who recognized the severity of the symptoms and had a greater fear of the disease. They are at least high school educated, employed, and living in major cities (p < 0.05). Factors associated with a shorter SDT were: diagnosis determined by a specialist, at least secondary education, employment and life in a bigger city, and recognition of the symptoms severity (p < 0.05). Longer TDT was associated with advanced disease, estimated as tumor size, nodes involvement and presence of metastasis (p < 0.05).

Conclusions

Several factors, mainly related to psychological and behavioral attributes, strongly determined both delay in seeking medical advice and treatment onset for breast cancer, indicating the need for implementing measures to raise awareness about the importance of early reporting to the doctor after noticing symptoms.

Disclosure

L. Stamatovic: The study conducted in order to collect the data was sponsored by Roche; S.D. Mamula Masic: Full time employee of Roche; D. Vukotic: The study conducted in order to collect the data was sponsored by Roche; Z. Kovac: The study conducted in order to collect the data was sponsored by Roche; Z. Mihailovic: The study conducted in order to collect the data was sponsored by Roche; K. Zdravkovic: The study conducted in order to collect the data was sponsored by Roche; D. Petkovic: The study conducted in order to collect the data was sponsored by Roche; T. Bagi: The study conducted in order to collect the data was sponsored by Roche; N. Milic: The study conducted in order to collect the data was sponsored by Roche. I have been done statistical analysis for this abstract.