REASONS FOR DELAY IN BREAST-CANCER DIAGNOSIS

Background. A study of system delay, the time between the initial medi cal consultation and the establishment of a diagnosis, in breast cance r patients revealed that almost 40% of women reported delays of at lea st 4 weeks. The objective of this study was to explore the reasons for these prolonged intervals between initial medical consultation and es tablishment of a diagnosis. Methods. A total of 367 female breast canc er patients from the National Cancer Institute's Black/White Cancer Su rvival Study were studied, Medical systems involved in the diagnosis a nd treatment of these women included hospital outpatient and emergency room, private clinic, public clinic, private doctor, and health maint enance organization. Results. In about 25% of the cases, the delay was attributed by the woman to the patient herself, and the most common r eason she gave was that she felt that the problem was not important. I n about 45% of the cases, the provider and the health care system were said to be responsible for the delay through difficulties in scheduli ng or physician inaction, while in another 17% both the patient and th e system were responsible. Conclusions. This study looked at the issue of how the behaviors of women and their providers contribute to the t iming of breast cancer diagnosis. It is one of the only studies to exa mine the woman's role in delay. It is clear from this study that addit ional work is needed to look at this question. However, the results of this study suggest that efforts must be made to reduce the time neede d to get an appointment with a physician or a diagnostic test, as well as to educate physicians and the women themselves regarding the impor tance of breast symptoms and the value of prompt evaluation, diagnosis , and treatment. (C) 1996 Academic Press, Inc.