Patient and Diagnostic Delay in Patients With Breast or Colorectal Cancer
Author(s)
Réka Vajda, M.Sc., Ph.D.1, Tímea Nagy, MSc1, Annamaria Pakai, M.Sc, Ph.D, habil.2, Tímea Csákvári, MSc, PhD3, Zsuzsanna Kívés, MSc, PhD1, Patricia Szántóri, MSc4, István Pósa, MD, M.Sc.1, Imre Boncz, MSc, PhD, MD1;
1University of Pécs, Faculty of Health Sciences, Institute for Health Insurance, Pécs, Hungary, 2University of Pécs, Faculty of Health Sciences, Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, Szombathely, Hungary, 3University of Pécs, Faculty of Health Sciences, Institute for Health Insurance, Zalaegerszeg, Hungary, 4University of Pécs, Faculty of Health Sciences, Institute of Human Nutrition and Dietetics, Pécs, Hungary
1University of Pécs, Faculty of Health Sciences, Institute for Health Insurance, Pécs, Hungary, 2University of Pécs, Faculty of Health Sciences, Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, Szombathely, Hungary, 3University of Pécs, Faculty of Health Sciences, Institute for Health Insurance, Zalaegerszeg, Hungary, 4University of Pécs, Faculty of Health Sciences, Institute of Human Nutrition and Dietetics, Pécs, Hungary
OBJECTIVES: Early detection is crucial for better prognosis especially where advanced cancer stages are common. Delays in the onset of symptoms or diagnosis can result in a poor prognosis and contribute significantly to mortality. The aim of our study was to investigate the patient- and diagnostic delays and the factors influencing them among patients with malignant breast and colorectal cancer.
METHODS: A retrospective document analysis based on quantitative data from the ENCI-HIS 2.0 medical system of the Oncology Care Unit of the Hospital of Nagyatád (n=272) for the period 2003-2023 was performed. For data analysis, in addition to descriptive statistical analysis (mean, standard deviation, absolute and relative frequencies), we used chi-square test, independent samples t-test, ANOVA, odds ratio, Kaplan-Meier survival analysis and Cox regression analysis at 95% probability level (p<0.05) using SPSS 27.0 software.
RESULTS: Patients with breast cancer almost twice as many patients presenting to the health system within 30 days of the onset of the first symptom (OR=1.967 95%CI[1.158; 3.341], p=0.017) as in patients with gastrointestinal disease. Tumor location is significantly (p‹0.001) associated with survival. The median survival of breast cancer patients was 362 months (95% CI, 327-397 months), and that of colorectal cancer patients was 190 months (95% CI, 160-220 months). Lymph node involvement (HR=2.818 95% CI[1.284; 6.188], p=0.010) and the presence of metastasis (HR=4.394 95% CI[2.209; 8.740], p‹0.001) also reduce survival time. Screening was a protective predictor of increased survival (HR=0.313 95% CI[0.136;0.717], p=0.006) and among the symptoms that led patients to seek care in breast cancer patients were skin redness (HR=0.060 95% CI[0.006;0.583], p=0.016) and breast discharge (HR=0.058 95% CI[0.006;0.517], p=0.011).
CONCLUSIONS: This study highlights the significant problem of patient delay among cancer patients. A comprehensive approach addressing both individual barriers and institutional obstacles is imperative to mitigate this patient delay and improve cancer outcomes.
METHODS: A retrospective document analysis based on quantitative data from the ENCI-HIS 2.0 medical system of the Oncology Care Unit of the Hospital of Nagyatád (n=272) for the period 2003-2023 was performed. For data analysis, in addition to descriptive statistical analysis (mean, standard deviation, absolute and relative frequencies), we used chi-square test, independent samples t-test, ANOVA, odds ratio, Kaplan-Meier survival analysis and Cox regression analysis at 95% probability level (p<0.05) using SPSS 27.0 software.
RESULTS: Patients with breast cancer almost twice as many patients presenting to the health system within 30 days of the onset of the first symptom (OR=1.967 95%CI[1.158; 3.341], p=0.017) as in patients with gastrointestinal disease. Tumor location is significantly (p‹0.001) associated with survival. The median survival of breast cancer patients was 362 months (95% CI, 327-397 months), and that of colorectal cancer patients was 190 months (95% CI, 160-220 months). Lymph node involvement (HR=2.818 95% CI[1.284; 6.188], p=0.010) and the presence of metastasis (HR=4.394 95% CI[2.209; 8.740], p‹0.001) also reduce survival time. Screening was a protective predictor of increased survival (HR=0.313 95% CI[0.136;0.717], p=0.006) and among the symptoms that led patients to seek care in breast cancer patients were skin redness (HR=0.060 95% CI[0.006;0.583], p=0.016) and breast discharge (HR=0.058 95% CI[0.006;0.517], p=0.011).
CONCLUSIONS: This study highlights the significant problem of patient delay among cancer patients. A comprehensive approach addressing both individual barriers and institutional obstacles is imperative to mitigate this patient delay and improve cancer outcomes.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HSD77
Topic
Health Service Delivery & Process of Care
Disease
SDC: Oncology