Sadullah GİRGİN, Hatice GÜMÜŞ, Ömer USLUKAYA, Zübeyir BOZDAĞ, Eyüp ÖNER, Zuhat URAKÇI, Metehan GÜMÜŞ

Güneydoğu Anadolu bölgesinde meme kanserinde tanı ve tedavide gecikme sebeplerine yönelik anket çalışması

Amaç: Meme kanserinde, bölgemizde hasta ve sağlık sistemi ilişkili gecikmede etkili olan faktörleri incelemektir.Yöntemler: 2012 Aralık-2014 Temmuz tarihleri arasında Dicle Üniversitesi Tıp Fakültesi Hastanesi Genel Cerrahi Kliniğine başvuran son 6 ay içerisinde Meme Kanseri tanısı almış 100 meme kanserli hastaya, hasta onamı alındıktan sonra anket uygulandı. Anket 4 bölüm (hasta ve sistem ilişkili faktörler, demografik veriler ve kanser evresinin değerlendirilmesi) ve 25 sorudan oluşmaktaydı. Bulgular: Meme semptomlarını fark ettikten sonra, üç ay gecikme ile gelenlerin oranı ise %58 idi. Düzenli kontrol edilenlerin oranı %8 idi. Memedeki lezyonunun kanser olabileceğini düşünenlerin oranı %9 iken, bunun ciddi bir durum olmadığını ve kendiliğinden iyileşeceğini düşünenlerin oranı %86 idi. Doktora gitmeme nedenine yönelik soruya, hastaların % 2'si bayan doktor olmadığı için, %7'si bilgisizlikten, %23'ü korktuğundan şeklinde cevap verdi. Hastaların %77' si bir hafta içinde doktor randevusu alabilmiş, %82'si bir hafta içinde mamografi çekimi yapabilmiş, %78'i bir hafta içinde meme biyopsi işlemini yapabilmişti. Kanser korkusu 30-50 yaş aralığındaki kadınlarda istatistiksel anlamlı yüksekti (p

A survey on the factors causing delayed diagnosis and treatment of breast cancer in southeastern Anatolia

Objective: This survey aims to elucidate patient and health system related factors leading to delayed diagnosis and treatment of breast cancer in Southeastern Anatolia.Methods: Hundred patients admitted to Department of General Surgery at Dicle University between December 2012 and July 2014, and diagnosed with breast cancer in preceding 6 months were included in the survey after their consent. The survey has 4 chapters (patient and health system related factors, demographic data, and assessment of cancer stage) and 25 questions.Results: Fifty-eight percent of patients visited a physician with a 3 months delay after realization of breast cancer symptoms. Only 8% of patients had regular check-ups. Nine percent of patients were suspicious of breast cancer due to the lesion in the breast. 86% of patients did not consider it to be a serious matter. Lack of female physicians cited by 2% as the reason for avoiding doctor's visit. Seven percent cited lack of knowledge and 23% being scared. Seventy-seven percent were able to get a doctor's appointment, 82% to get mammography, 78% underwent biopsy in a week. Women between the ages of 30-50 had higher concern about cancer (p

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Surveillance, Epidemiology, and Results (SEER). Program (www.seer.cancer.gov): SEER Stat Database: Incidence- SEER 9 Regs Public Use, Nov 2005 Sub (1973-2003). National Cancer Institute, Division of Cancer Control and Population Sciences, Surveillance Research Program, Cancer Statistics Branch, released April 2006, based on the November 2005 submission.
Berry DA, Cronin KA, Plevritis SK, et al. Cancer Intervention and Surveillance Modeling Network (CISNET) Collabora- tors: Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med 2005;353:1784-1792.
Shetty MK, Longatto-Filho A. Early detection of breast, cer- vical, ovarian and endometrial cancers in low resource contries: an integrated approach. Indian J Surg Oncol 2011;2:165-171.
Dundar PE, Ozmen D, Ozturk B, et al. The knowledge and attitudes of breast self-examination and mammography in a group of women in rural area in western Turkey. BMC Cancer 2006;6:43.
Saip P, Keskin S, Ozkan M,et al. The access rate to di- agnosis and treatment modalities in breast cancer pa- tients in Turkey; multicenter observational study. J BUON 2011;16:664-671.
Ozmen V, Ozaydin N, Cabioglu N, et al. Survey on a mam- mographic screening program in Istanbul Turkey. Breast J 2011;17:260-267.
Shin DW, Cho J, Kim SY, et al. Delay to curative surgery greater than 12 weeks is associated with increased mor- tality in patients with colorectal and breast cancer but not lung or thyroid cancer. Ann Surg Oncol 2013:20;2468- 2476.
Rutqvist LE. Waiting times for cancer patients--a "slippery slope" in oncology. Acta Oncol 2006;45:121-123.
Richards MA. The national awareness and early diagnosis initiative in England: assembling the evidence. Br J Can- cer 2009:3;101 Suppl 2:S1-4.
Partridge AH, Hughes ME, Ottesen RA, et al. The effect of age on delay in diagnosis and stage of breast cancer. Oncologist 2012;17:775-782.
Sikora K. Genes, dreams, and cancer. MJ 1994:7;1217- 1221.
Ozmen V, Boylu S, Ok E, et al. Factors affecting breast cancer treatment delay in Turkey: a study from Turkish Federation of Breast Diseases Societies. Eur J Public Health 2015;25:9-14.
Fedewa SA, Edge SB, Stewart AK, et al. Race and eth- nicity are associated with delays in breast cancer treat- ment (2003-2006). J Health Care Poor Underserved 2011;22:128-141.
Hansen RP, Vedsted P, Sokolowski I, et al. Time intervals from first symptom to treatment of cancer: a cohort study of 2,212 newly diagnosed cancer patients. BMC Health Serv Res 2011;11:284.
Otieno ES, Micheni JN, Kimende SK, Mutai KK. Provider delay in the diagnosis and initiation of definitive treatment for breast cancer patients. East Afr Med J 2010;87:143- 146.
Norsa'adah B, Rampal KG, Rahmah MA, et al. Diagnosis delay of breast cancer and its associated factors in Malay- sian women. BMC Cancer 2011;11:141-146.
Chintamani, Tuteja A, Khandelwal R, et al. Patient and provider delays in breast cancer patients attending a ter- tiary care centre: a prospective study. JRSM Short Rep 2011;2:76-82.
Jassem J, Bacanu F, Eglitis J, et al. Patient-related factors influencing time between first signs of breast cancer (BC) and appointment for medical visit (AVM): An international survey. J Clin Oncol 2012; 30, (suppl; abstr 9046).
Allgar VL, Neal RD. Delays in the diagnosis of six can- cers: analysis of data from the National Survey of NHS Patients: Cancer. Br J Cancer 2005;92:1959-1970.
Jassem J, Ozmen V, Bacanu F, et al. Factors influencing time to seeking medical advice and start of treatment in breast cancer - an international survey. Thirty-fifth Annual CTRC-AACR San Antonio Breast Cancer Symposium - December 4-8, 2012; San Antonio, TX (abstract).
Montella M, Crispo A, D'Aiuto G, et al. Determinant factors for diagnostic delay in operable breast cancer patients. Eur J Cancer Prev 2001;10:53-59.
Rauscher GH, Ferrans CE, Kaiser K, et al. Misconcep- tions about breast lumps and delayed medical presenta- tion in urban breast cancer patients. Cancer Epidemiol Biomarkers Prev 2010;19:640-647.
Robertson R, Campbell NC, Smith S, et al. Factors influ- encing time from presentation to treatment of colorectal and breast cancer in urban and rural areas. Br J Cancer 2004;90:1479-1485.
Yau TK, Choi CW, Ng E, et al. Delayed presentation of symptomatic breast cancers in Hong Kong: experience in a public cancer centre. Hong Kong Med J 2010;16:373- 377.
Hofvind S, Lee CI, Elmore JG. Stage-specific breast can- cer incidence rates among participants and non-partici- pants of a population-based mammographic screening program. Breast Cancer Res Treat 2012;135:291-299.
Kayhan A, Gurdal SO, Ozaydin N, et al. First round results of a long term population-based breast cancer screening program from Bahçesehir. J Breast Health 2012; 8:180- 184.
Fornier MN, Modi S, Panageas KS, Norton L. Incidence of chemotherapy-induced, long-term amenorrhea in patients with breast carcinoma age 40 years and younger after ad- juvant anthracycline and taxane. Cancer 2005;104:1575- 1579.
Online: Türkiye İstatistik Kurumu (Turkish Statistical In- stitute). Available at http://www.tuik.gov.tr [accessed: July 2013].
Jensen LF, Pedersen AF, Andersen B, Vedsted P. Identify- ing specific non-attending groups in breast cancer screen- ing - population-based registry study of participation and socio-demography. BMC Cancer 2012;12:518-522.