Diagnosis delay of breast cancer and its associated factors in Malaysian women

Bachok Norsa'adah, Krishna G. Rampal, Rahmah Mohd Amin, Nyi N. Naing, Biswa M. Biswal

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Background: Breast cancer is the leading cause of cancer mortality among women in Malaysia. Delayed diagnosis is preventable and has major effects on patients' prognosis and survival. The objectives of our study were to identify the magnitude of delayed diagnosis and its associated factors in women with breast cancer in Malaysia.Methods: This study had a cross-sectional design. Respondents had histologically confirmed breast cancer and were registered at five medical centres between 2005 and 2007. All breast cancer patients who attended hospital clinics at the East Coast were included. Patients at Kuala Lumpur hospitals were selected by systematic sampling. A standardised questionnaire was developed to interview respondents. We measured the time from the first recognition of symptoms to the first general practitioners' consultation and to the histological diagnosis of breast cancer. Diagnosis delay was defined when there was more than 6 months from the recognition of symptoms to the histological diagnosis. Multiple logistic regression was used for analysis.Results: In total, 328 respondents were included. The mean (standard deviation) age was 47.9 (9.4) years. Most respondents were of Malay ethnicity, were married housewives with a median family income of RM1500 a month. Most respondents had ductal carcinoma (89.3%) and the stage distribution was as follows: 5.2% stage I, 38.7% stage II, 44.8% stage III and 11.3% stage IV. The median time to consultation was 2 months and the median time to diagnosis was 5.5 months. The frequency of diagnosis delay of more than 3 months was 72.6% and delay of more than 6 months occurred in 45.5% of the cases. The factors associated with diagnosis delay included the use of alternative therapy (odds ratio (OR) 1.77; 95% confidence interval (CI): 1.06, 2.94), breast ulcer (OR 5.71; 95% CI: 1.59, 20.47), palpable axillary lymph nodes (OR 2.19; 95% CI: 1.23, 3.90), false-negative diagnostic test (OR 5.32; 95% CI: 2.32, 12.21), non-cancer interpretation (OR 1.68; 95% CI: 1.01, 2.78) and negative attitude toward treatment (OR 2.09; 95% CI: 1.15, 3.82).Conclusions: Delays in consultation and diagnosis are serious problems in Malaysia. Diagnosis delay was influenced by complex interactions between many factors. Breast awareness and education are required to promote early detection, diagnosis and treatment before the tumours enlarge and metastasis.

Original languageEnglish
Article number141
JournalBMC Cancer
Volume11
DOIs
Publication statusPublished - 17 Apr 2011

Fingerprint

Breast Neoplasms
Odds Ratio
Confidence Intervals
Malaysia
Referral and Consultation
Delayed Diagnosis
Breast
Ductal Carcinoma
neoplasm-associated factor
Complementary Therapies
Routine Diagnostic Tests
General Practitioners
Ulcer
Surveys and Questionnaires
Early Diagnosis
Neoplasms
Logistic Models
Lymph Nodes
Interviews
Neoplasm Metastasis

Keywords

  • Breast cancer diagnosis delay
  • Consultation delay
  • Patient delay
  • Presentation delay

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Genetics

Cite this

Norsa'adah, B., Rampal, K. G., Mohd Amin, R., Naing, N. N., & Biswal, B. M. (2011). Diagnosis delay of breast cancer and its associated factors in Malaysian women. BMC Cancer, 11, [141]. https://doi.org/10.1186/1471-2407-11-141

Diagnosis delay of breast cancer and its associated factors in Malaysian women. / Norsa'adah, Bachok; Rampal, Krishna G.; Mohd Amin, Rahmah; Naing, Nyi N.; Biswal, Biswa M.

In: BMC Cancer, Vol. 11, 141, 17.04.2011.

Research output: Contribution to journalArticle

Norsa'adah, B, Rampal, KG, Mohd Amin, R, Naing, NN & Biswal, BM 2011, 'Diagnosis delay of breast cancer and its associated factors in Malaysian women', BMC Cancer, vol. 11, 141. https://doi.org/10.1186/1471-2407-11-141
Norsa'adah, Bachok ; Rampal, Krishna G. ; Mohd Amin, Rahmah ; Naing, Nyi N. ; Biswal, Biswa M. / Diagnosis delay of breast cancer and its associated factors in Malaysian women. In: BMC Cancer. 2011 ; Vol. 11.
@article{81343f3279d74ac9b8dca83f9937b7ec,
title = "Diagnosis delay of breast cancer and its associated factors in Malaysian women",
abstract = "Background: Breast cancer is the leading cause of cancer mortality among women in Malaysia. Delayed diagnosis is preventable and has major effects on patients' prognosis and survival. The objectives of our study were to identify the magnitude of delayed diagnosis and its associated factors in women with breast cancer in Malaysia.Methods: This study had a cross-sectional design. Respondents had histologically confirmed breast cancer and were registered at five medical centres between 2005 and 2007. All breast cancer patients who attended hospital clinics at the East Coast were included. Patients at Kuala Lumpur hospitals were selected by systematic sampling. A standardised questionnaire was developed to interview respondents. We measured the time from the first recognition of symptoms to the first general practitioners' consultation and to the histological diagnosis of breast cancer. Diagnosis delay was defined when there was more than 6 months from the recognition of symptoms to the histological diagnosis. Multiple logistic regression was used for analysis.Results: In total, 328 respondents were included. The mean (standard deviation) age was 47.9 (9.4) years. Most respondents were of Malay ethnicity, were married housewives with a median family income of RM1500 a month. Most respondents had ductal carcinoma (89.3{\%}) and the stage distribution was as follows: 5.2{\%} stage I, 38.7{\%} stage II, 44.8{\%} stage III and 11.3{\%} stage IV. The median time to consultation was 2 months and the median time to diagnosis was 5.5 months. The frequency of diagnosis delay of more than 3 months was 72.6{\%} and delay of more than 6 months occurred in 45.5{\%} of the cases. The factors associated with diagnosis delay included the use of alternative therapy (odds ratio (OR) 1.77; 95{\%} confidence interval (CI): 1.06, 2.94), breast ulcer (OR 5.71; 95{\%} CI: 1.59, 20.47), palpable axillary lymph nodes (OR 2.19; 95{\%} CI: 1.23, 3.90), false-negative diagnostic test (OR 5.32; 95{\%} CI: 2.32, 12.21), non-cancer interpretation (OR 1.68; 95{\%} CI: 1.01, 2.78) and negative attitude toward treatment (OR 2.09; 95{\%} CI: 1.15, 3.82).Conclusions: Delays in consultation and diagnosis are serious problems in Malaysia. Diagnosis delay was influenced by complex interactions between many factors. Breast awareness and education are required to promote early detection, diagnosis and treatment before the tumours enlarge and metastasis.",
keywords = "Breast cancer diagnosis delay, Consultation delay, Patient delay, Presentation delay",
author = "Bachok Norsa'adah and Rampal, {Krishna G.} and {Mohd Amin}, Rahmah and Naing, {Nyi N.} and Biswal, {Biswa M.}",
year = "2011",
month = "4",
day = "17",
doi = "10.1186/1471-2407-11-141",
language = "English",
volume = "11",
journal = "BMC Cancer",
issn = "1471-2407",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Diagnosis delay of breast cancer and its associated factors in Malaysian women

AU - Norsa'adah, Bachok

AU - Rampal, Krishna G.

AU - Mohd Amin, Rahmah

AU - Naing, Nyi N.

AU - Biswal, Biswa M.

PY - 2011/4/17

Y1 - 2011/4/17

N2 - Background: Breast cancer is the leading cause of cancer mortality among women in Malaysia. Delayed diagnosis is preventable and has major effects on patients' prognosis and survival. The objectives of our study were to identify the magnitude of delayed diagnosis and its associated factors in women with breast cancer in Malaysia.Methods: This study had a cross-sectional design. Respondents had histologically confirmed breast cancer and were registered at five medical centres between 2005 and 2007. All breast cancer patients who attended hospital clinics at the East Coast were included. Patients at Kuala Lumpur hospitals were selected by systematic sampling. A standardised questionnaire was developed to interview respondents. We measured the time from the first recognition of symptoms to the first general practitioners' consultation and to the histological diagnosis of breast cancer. Diagnosis delay was defined when there was more than 6 months from the recognition of symptoms to the histological diagnosis. Multiple logistic regression was used for analysis.Results: In total, 328 respondents were included. The mean (standard deviation) age was 47.9 (9.4) years. Most respondents were of Malay ethnicity, were married housewives with a median family income of RM1500 a month. Most respondents had ductal carcinoma (89.3%) and the stage distribution was as follows: 5.2% stage I, 38.7% stage II, 44.8% stage III and 11.3% stage IV. The median time to consultation was 2 months and the median time to diagnosis was 5.5 months. The frequency of diagnosis delay of more than 3 months was 72.6% and delay of more than 6 months occurred in 45.5% of the cases. The factors associated with diagnosis delay included the use of alternative therapy (odds ratio (OR) 1.77; 95% confidence interval (CI): 1.06, 2.94), breast ulcer (OR 5.71; 95% CI: 1.59, 20.47), palpable axillary lymph nodes (OR 2.19; 95% CI: 1.23, 3.90), false-negative diagnostic test (OR 5.32; 95% CI: 2.32, 12.21), non-cancer interpretation (OR 1.68; 95% CI: 1.01, 2.78) and negative attitude toward treatment (OR 2.09; 95% CI: 1.15, 3.82).Conclusions: Delays in consultation and diagnosis are serious problems in Malaysia. Diagnosis delay was influenced by complex interactions between many factors. Breast awareness and education are required to promote early detection, diagnosis and treatment before the tumours enlarge and metastasis.

AB - Background: Breast cancer is the leading cause of cancer mortality among women in Malaysia. Delayed diagnosis is preventable and has major effects on patients' prognosis and survival. The objectives of our study were to identify the magnitude of delayed diagnosis and its associated factors in women with breast cancer in Malaysia.Methods: This study had a cross-sectional design. Respondents had histologically confirmed breast cancer and were registered at five medical centres between 2005 and 2007. All breast cancer patients who attended hospital clinics at the East Coast were included. Patients at Kuala Lumpur hospitals were selected by systematic sampling. A standardised questionnaire was developed to interview respondents. We measured the time from the first recognition of symptoms to the first general practitioners' consultation and to the histological diagnosis of breast cancer. Diagnosis delay was defined when there was more than 6 months from the recognition of symptoms to the histological diagnosis. Multiple logistic regression was used for analysis.Results: In total, 328 respondents were included. The mean (standard deviation) age was 47.9 (9.4) years. Most respondents were of Malay ethnicity, were married housewives with a median family income of RM1500 a month. Most respondents had ductal carcinoma (89.3%) and the stage distribution was as follows: 5.2% stage I, 38.7% stage II, 44.8% stage III and 11.3% stage IV. The median time to consultation was 2 months and the median time to diagnosis was 5.5 months. The frequency of diagnosis delay of more than 3 months was 72.6% and delay of more than 6 months occurred in 45.5% of the cases. The factors associated with diagnosis delay included the use of alternative therapy (odds ratio (OR) 1.77; 95% confidence interval (CI): 1.06, 2.94), breast ulcer (OR 5.71; 95% CI: 1.59, 20.47), palpable axillary lymph nodes (OR 2.19; 95% CI: 1.23, 3.90), false-negative diagnostic test (OR 5.32; 95% CI: 2.32, 12.21), non-cancer interpretation (OR 1.68; 95% CI: 1.01, 2.78) and negative attitude toward treatment (OR 2.09; 95% CI: 1.15, 3.82).Conclusions: Delays in consultation and diagnosis are serious problems in Malaysia. Diagnosis delay was influenced by complex interactions between many factors. Breast awareness and education are required to promote early detection, diagnosis and treatment before the tumours enlarge and metastasis.

KW - Breast cancer diagnosis delay

KW - Consultation delay

KW - Patient delay

KW - Presentation delay

UR - http://www.scopus.com/inward/record.url?scp=79955110840&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79955110840&partnerID=8YFLogxK

U2 - 10.1186/1471-2407-11-141

DO - 10.1186/1471-2407-11-141

M3 - Article

C2 - 21496310

AN - SCOPUS:79955110840

VL - 11

JO - BMC Cancer

JF - BMC Cancer

SN - 1471-2407

M1 - 141

ER -