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Poster session 10

1570P - Factors and impacts of delayed presentation for county-level patients with breast cancer in a real-life setting in China

Date

14 Sep 2024

Session

Poster session 10

Topics

Cancer Care Equity Principles and Health Economics

Tumour Site

Breast Cancer

Presenters

Yinghua Ji

Citation

Annals of Oncology (2024) 35 (suppl_2): S937-S961. 10.1016/annonc/annonc1606

Authors

Y. Ji1, F. Zhou2, H. Qu3, J. Wang4, M. Liu5, W. Liang6, G. Dai7, Q. Wu8, J. Luo9, X. Tan10, G. Hu11, H. Wang12, Q. Meng13, Y. Ren14, W. liu15, W. He16, Z. Qin17, H. Tang18, H. Liu19, Z. Yu20

Author affiliations

  • 1 Oncology Department, The First Affiliated Hospital of Xinxiang Medical University, 453110 - Xinxiang/CN
  • 2 Breast Surgery, The People's Hospital of Liuyang, Changsha/CN
  • 3 Oncology Department, Inner Mongolia Forestry General Hospital, Hulunbeier/CN
  • 4 Breast Surgery, Honghe Prefecture Third People's Hospital, Honghe/CN
  • 5 Breast Surgery, Lixin County People's Hospital, Bozhou/CN
  • 6 Radiotherapy Department, Huixian People's Hospital, 453601 - Xinxiang/CN
  • 7 Oncology Department, Pingyu County People's Hospital, Zhumadian/CN
  • 8 Breast Surgery, Guiping People's Hospital, Guigang/CN
  • 9 Breast Surgery, Fengcheng People's Hospital, Yichun/CN
  • 10 Oncology Department, Anyue County People's Hospital, Ziyang/CN
  • 11 Surgical Oncology, Dongyang People's Hospital, Jinhua/CN
  • 12 Oncology Dept., TengZhou Central People's Hospital, 277500 - Tengzhou/CN
  • 13 Oncology Department, Gongyi City People's Hospital, Zhengzhou/CN
  • 14 Breast Surgery, Taihe County People's Hospital, Fuyang/CN
  • 15 Breast Surgery, Xiantao First People's Hospital, Xiantao/CN
  • 16 Breast Surgery, Dingzhou City People's Hospital, Dingzhou/CN
  • 17 Breast Surgery, People's Hospital of Lixian, Changde/CN
  • 18 Oncology Department, Central Hospital of Zhuanghe City, Dalian/CN
  • 19 General Surgery Department, Dingyuan General Hospital, Chuzhou/CN
  • 20 Cancer Center, Central Hospital of Qinghe, Xingtai/CN

Resources

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Abstract 1570P

Background

New breast cancer (BC) cases in county regions, including rural areas, account for 33% of all BC cases annually in China. Women residing in county areas generally have lower economic income and educational levels compared to urban women, lacking the access to medical resources. We utilized real-world data to explore the factors and impacts of delayed presentation for BC patients (pts) in county areas.

Methods

CHASE001 (NCT05544123) was an observational, multicenter study assessing real-world treatment patterns among BC pts in county areas of China. Descriptive statistics reported patient intervals and demographics. Multivariate regression analyses (MVA) and rank-sum test were used to analyze factors and impacts associated with delayed presentation.

Results

This analysis included 2405 BC pts with pathological diagnosis from February 2001 to July 2023. The median time from symptom onset to the first presentation to a healthcare professional was 1.0 month (IQR 0.3-5.0). the proportion of delayed presentation (intervals≥3 months) was 28.4%. The median interval among pts with delayed presentation was 12.0 months (IQR 6.0, 24.0). MVA revealed that lower education levels (OR 1.37 [95% CI 1.13-1.67]; p=.002), lack of breast screening (OR 1.42 [95% CI 1.06-1.91]; p=.019), being farmers and unemployed (OR 1.36 [95% CI 1.01-1.83]; p=.045), and residing in county areas in western China (OR 1.71 [95% CI 1.38-2.12]; p<.001) were significantly associated with delayed presentation. The rank-sum test demonstrated that delayed presentation was linked with higher disease burden. The proportion of pts with delayed presentation diagnosed with stage III-IV (p<.001), tumor size≥2cm (p<.001), and more than three positive lymph nodes (p=.005) was significantly higher than those who sought timely care.

Conclusions

This analysis indicates that patient delays are influenced by social determinants of health. Lower socioeconomic status and education levels are risk factors for delayed presentation, and medical resources are unevenly distributed across regions. Therefore, promoting early presentation through advocacy, education, and policy should be prioritized, especially targeting socially deprived and less educated populations.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

AstraZeneca.

Disclosure

All authors have declared no conflicts of interest.

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