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

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.