What influences diagnostic delay in low-income women with breast cancer?

Rose C. Maly, Barbara Leake, Cynthia M. Mojica, Yihang Liu, Allison L. Diamant, Amardeep Thind

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: Delayed diagnosis of breast cancer (BC) may contribute to adverse outcomes, such as reduced survival. The purpose of this study was to identify correlates of elapsed time between recognition of breast abnormalities and receipt of definitive diagnosis of BC among low-income women. Methods: Data were obtained from a cross-sectional study among a statewide sample of 921 low-income women with a new diagnosis of BC. Patients were grouped by whether their breast abnormalities were self-detected or healthcare system detected. Multivariate logistic regression analyses were used to examine associations between diagnostic delay and patient characteristics, patient communication, and system characteristics. Results: The self-detected group experienced much greater delay than the system-detected group (median intervals 80.5 vs. 31.5 days). African Americans had the longest intervals between symptom detection and diagnostic resolution; median delays in the self-detected and system-detected subgroups were 115 and 70 days, respectively, compared to 64 and 22 days for Caucasians. In multivariate analyses, African Americans had considerably greater odds of >60-day delay than Caucasians in both the self-detected (odds ratio [OR] 3.51) and system-detected (OR 5.36) groups. Greater perceived self-efficacy in interacting with healthcare providers was significantly associated with shorter delay among the self-detected group (OR 0.86). Conclusions: Disparities in timely BC diagnosis between African Americans and Caucasians were pronounced in this uniformly low-income population of women. Women with self-detected abnormalities had markedly greater delays than those with healthcare system-detected abnormalities. Among this vulnerable group, increasing self-efficacy in interacting with healthcare providers may reduce diagnostic delays.

Original languageEnglish (US)
Pages (from-to)1017-1023
Number of pages7
JournalJournal of Women's Health
Volume20
Issue number7
DOIs
StatePublished - Jul 1 2011
Externally publishedYes

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African Americans
Breast Neoplasms
Odds Ratio
Self Efficacy
Health Personnel
Breast
Delivery of Health Care
Delayed Diagnosis
Poverty
Multivariate Analysis
Cross-Sectional Studies
Logistic Models
Communication
Regression Analysis
Survival

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Maly, R. C., Leake, B., Mojica, C. M., Liu, Y., Diamant, A. L., & Thind, A. (2011). What influences diagnostic delay in low-income women with breast cancer? Journal of Women's Health, 20(7), 1017-1023. https://doi.org/10.1089/jwh.2010.2105

What influences diagnostic delay in low-income women with breast cancer? / Maly, Rose C.; Leake, Barbara; Mojica, Cynthia M.; Liu, Yihang; Diamant, Allison L.; Thind, Amardeep.

In: Journal of Women's Health, Vol. 20, No. 7, 01.07.2011, p. 1017-1023.

Research output: Contribution to journalArticle

Maly, RC, Leake, B, Mojica, CM, Liu, Y, Diamant, AL & Thind, A 2011, 'What influences diagnostic delay in low-income women with breast cancer?', Journal of Women's Health, vol. 20, no. 7, pp. 1017-1023. https://doi.org/10.1089/jwh.2010.2105
Maly, Rose C. ; Leake, Barbara ; Mojica, Cynthia M. ; Liu, Yihang ; Diamant, Allison L. ; Thind, Amardeep. / What influences diagnostic delay in low-income women with breast cancer?. In: Journal of Women's Health. 2011 ; Vol. 20, No. 7. pp. 1017-1023.
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