Factors affecting breast cancer treatment delay in Turkey: a study from Turkish Federation of Breast Diseases Societies

Abstract

Background: One of the most important factors in breast cancer (BC) mortality is treatment delay. The primary goal of this survey was to identify factors affecting the total delay time (TDT) in Turkish BC patients. Methods: A total of 1031 patients with BC were surveyed using a uniform questionnaire. The time between discovering the first symptom and signing up for the first medical visit (patient delay time; PDT) and the time between the first medical visit and the start of therapy (system delay time; SDT) were modelled separately with multilevel regression. Results: The mean PDT, SDT and TDT were 4.8, 10.5 and 13.8 weeks, respectively. In all, 42% of the patients had a TDT >12 weeks. Longer PDT was significantly correlated with disregarding symptoms and having age of between 30 and 39 years. Shorter PDT was characteristic of patients who: had stronger self-examination habits, received more support from family and friends and had at least secondary education. Predictors of longer SDT included disregard of symptoms, distrust in success of therapy and medical system and having PDT in excess of 4 weeks. Shorter SDT was linked to the age of >60 years. Patients who were diagnosed during a periodic check-up or opportunistic mammography displayed shorter SDT compared with those who had symptomatic BC and their first medical examination was by a surgeon. Conclusion: TDT in Turkey is long and remains a major problem. Delays can be reduced by increasing BC awareness, implementing organized population-based screening programmes and founding cancer centres.

Predictors Affecting Breast Self-Examination Practice among Turkish Women

“…In this context, the Turkish Ministry of Health declared that all females beginning at the age of 20 years should practice BSE and admitted for clinical breast examination (CBE) (Republic of Turkey, 2008). Although the screening of females aged 40-69 years is free of charge in all cancer control departments, the attendance rates for early diagnose methods are not at expected levels most probably due to the lack of organized nationwide breast health screening program in Turkey (Ozmen et al, 2014). In this case, a BSE on a regular basis has an essential importance in Turkish women lives for the risk of this special disease growing steadily in numbers.…”

Turkish Ministry of Health, 2nd Turkish Medical General Assembly Clinical Oncology Study Group Report

“…The rates of stage 0 and I breast cancer are 5% and 27%, respectively, according to the Turkish Federation of Breast Diseases Societies' (Türkiye Meme Hastalıkları Dernekleri Federasyonu-TMHDF) database, which includes more than 22 000 patients (10). There is also a delay in initiating treatment for advanced-stage cancer because of patient and systemrelated factors (12). In our study, which included 1038 patients with breast cancer, the total delay to treatment initiation was 14.8 weeks, most of which was related with the health system (10.5 weeks) (12).…”

“…There is also a delay in initiating treatment for advanced-stage cancer because of patient and systemrelated factors (12). In our study, which included 1038 patients with breast cancer, the total delay to treatment initiation was 14.8 weeks, most of which was related with the health system (10.5 weeks) (12).…”

“…This study investigated whether surgery offers benefit to patients diagnosed as having metastatic disease; the 3-year follow-up results will be published next year. In addition, national and international multicenter studies that evaluated factors that caused delays in breast cancer diagnosis proved that considerable prospective clinical studies could be undertaken in our country (12). Moreover, the İstanbul University Oncology Institute Genetics Center is performing significant studies along with other university genetics and molecular research centers.…”

Controversies on Mammography Screening in the World and Bahceşehir Population-Based Organized Mammography Screening Project in Turkey

“…In our country, where the period from the occurrence of breast cancer symptoms until the beginning of treatment is 14 months, the significance of improving awareness and implementation of populationbased mammography screening programs is apparent (16). The 7-year results of Bahçeşehir Population-Based Mammographic Screening Program showed that screening can be performed in our country; the participation rate was 80% even in the 4th screening period; the rate of patients diagnosed with Stage 0 and I breast cancer was over 70%; and was in accordance with the rates in developed countries.…”