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The impact of rurality and disadvantage on the diagnostic interval for breast cancer in a large population-based study of 3202 women in Queensland, Australia

Youl, Philippa H., Aitken, Joanne F., Turrell, Gavin, Chambers, Suzanne K., Dunn, Jeffrey, Pyke, Christopher and Baade, Peter D. 2016, The impact of rurality and disadvantage on the diagnostic interval for breast cancer in a large population-based study of 3202 women in Queensland, Australia, International journal of environmental research and public health, vol. 13, no. 11, doi: 10.3390/ijerph13111156.

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Title The impact of rurality and disadvantage on the diagnostic interval for breast cancer in a large population-based study of 3202 women in Queensland, Australia
Author(s) Youl, Philippa H.
Aitken, Joanne F.
Turrell, GavinORCID iD for Turrell, Gavin orcid.org/0000-0002-3576-8744
Chambers, Suzanne K.
Dunn, Jeffrey
Pyke, Christopher
Baade, Peter D.
Journal name International journal of environmental research and public health
Volume number 13
Issue number 11
Total pages 20
Publisher MDPI
Place of publication Basel, Switzerland
Publication date 2016-11-19
ISSN 1661-7827
1660-4601
Keyword(s) breast cancer
delay
diagnosis
health system
inequalities
rurality
Science & Technology
Life Sciences & Biomedicine
Environmental Sciences
Public, Environmental & Occupational Health
Environmental Sciences & Ecology
FOLLOW-UP
PROGNOSTIC IMPLICATIONS
DELAYED PRESENTATION
WESTERN-AUSTRALIA
WHITE WOMEN
SURVIVAL
STAGE
SYMPTOMS
PATIENT
HELP
Summary Delays in diagnosing breast cancer (BC) can lead to poorer outcomes. We investigated factors related to the diagnostic interval in a population-based cohort of 3202 women diagnosed with BC in Queensland, Australia. Interviews ascertained method of detection and dates of medical/procedural appointments, and clinical information was obtained from medical records. Time intervals were calculated from self-recognition of symptoms (symptom-detected) or mammogram (screen-detected) to diagnosis (diagnostic interval (DI)). The cohort included 1560 women with symptom-detected and 1642 with screen-detected BC. Symptom-detected women had higher odds of DI of >60 days if they were Indigenous (OR = 3.12, 95% CI = 1.40, 6.98); lived in outer regional (OR = 1.50, 95% CI = 1.09, 2.06) or remote locations (OR = 2.46, 95% CI = 1.39, 4.38); or presented with a "non-lump" symptom (OR = 1.84, 95% CI = 1.43, 2.36). For screen-detected BC, women who were Indigenous (OR = 2.36, 95% CI = 1.03, 5.80); lived in remote locations (OR = 2.35, 95% CI = 1.24, 4.44); or disadvantaged areas (OR = 1.69, 95% CI = 1.17, 2.43) and attended a public screening facility (OR = 2.10, 95% CI = 1.40, 3.17) had higher odds of DI > 30 days. Our study indicates a disadvantage in terms of DI for rural, disadvantaged and Indigenous women. Difficulties in accessing primary care and diagnostic services are evident. There is a need to identify and implement an efficient and effective model of care to minimize avoidable longer diagnostic intervals.
Language eng
DOI 10.3390/ijerph13111156
Indigenous content off
Field of Research MD Multidisciplinary
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2016, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30117566

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.