scholarly journals Late-Stage Diagnosis of Breast Cancer in Brazil: Analysis of Data from Hospital-Based Cancer Registries (2000–2012)

2018 ◽  
Vol 40 (03) ◽  
pp. 127-136 ◽  
Author(s):  
Nelson Renna Junior ◽  
Gulnar Silva
Keyword(s):  
Breast Cancer ◽  
Late Stage ◽  
White Women ◽  
Multinomial Logistic Regression ◽  
College Education ◽  
Cancer Registries ◽  
Northern Region ◽  
Stage At Diagnosis ◽  
Annual Percent Change ◽  
Late Stage Diagnosis

Objective To analyze the time trend and the factors regarding the diagnosis of late-stage breast cancer in Brazil from 2000 to 2012. Methods We conducted a retrospective cohort study using data from hospital-based cancer registries. Joinpoint regression was used to analyze the time trends of stage at diagnosis. The risk of late-stage presentation was estimated using multinomial logistic regression. Results A total of 170,757 cases were analyzed. The median time from diagnosis to treatment was of 43 days (range: 0–182 days). The percentage of cases with late-stage diagnosis decreased from 2000 to 2002, with an annual percent change (APC) of -6.6% (95% confidence interval [95%CI]: -7.6–-5.5%); it increased from 2002 until 2009, with an APC of 1.1% (95% CI: 0.9–1.3%), and remained stable up to 2012. Women with college education (compared with illiterate women) had less chance of having a late-stage diagnosis (odds ratio [OR]: 0.32; 95%CI: 0.29–0.35). The odds were greater among brown women (OR: 1.30; 95%CI: 1.21–1.41) and black women (OR: 1.63; 95%CI: 1.47–1.82), compared with white women. The odds were also higher for women treated in facilities located and in the Northern region of Brazil (OR: 1.23; 95%CI: 1.04–1.45) and in the Midwest (OR: 1.61; 95%CI: 1.34–1.94), compared with those treated in the southern region of the country. Age, histological type, and marital status were some of the other factors that were positively related to staging at the diagnosis. Conclusion Access to diagnosis of breast cancer is uneven in Brazil, and women with lower socioeconomic status present a greater probability of having an advanced stage at diagnosis.

Distant metastases after diagnosis: Racial disparities in breast cancer outcomes.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1084-1084
Author(s):  
Julia Blanter ◽  
Ilana Ramer ◽  
Justina Ray ◽  
Emily J. Gallagher ◽  
Nina A. Bickell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Black Women ◽  
Racial Disparities ◽  
Late Stage ◽  
White Women ◽  
Univariate Analysis ◽  
Distant Metastases ◽  
Stage At Diagnosis

1084 Background: Black women diagnosed with breast cancer are more likely to have a poor prognosis, regardless of breast cancer subtype. Despite having a lower incidence rate of breast cancer when compared to white women, black women have the highest breast cancer death rate of all racial and ethnic groups, a characteristic often attributed to late stage at diagnosis. Distant metastases are considered the leading cause of death from breast cancer. We performed a follow up study of women with breast cancer in the Mount Sinai Health System (MSHS) to determine differences in distant metastases rates among black versus white women. Methods: Women were initially recruited as part of an NIH funded cross-sectional study from 2013-2020 to examine the link between insulin resistance (IR) and breast cancer prognosis. Women self-identified as black or white race. Data was collected via retrospective analysis of electronic medical records (EMR) between September 2020-January 2021. Distant metastases at diagnosis was defined as evidence of metastases in a secondary organ (not lymph node). Stage at diagnosis was recorded for all patients. Distant metastases after diagnosis was defined as evidence of metastases at any time after initiation of treatment. Univariate analysis was performed using Fisher’s exact test, multivariate analysis was performed by binary logistic regression, and results expressed as odds ratio (OR) and 95% confidence interval (CI). A p value <0.05 was considered statistically significant. Results: We identified 441 women enrolled in the IR study within the MSHS (340 white women, 101 black women). Median follow up time for all women was 2.95 years (median = 3.12 years for white and 2.51 years for black women (p=0.017)). Among these patients, 11 developed distant metastases after diagnosis: 4 (1.2%) white and 7 (6.9%) black (p=0.004). Multivariate analysis adjusting for age, race and stage at diagnosis revealed that black women were more likely to have distant metastasis (OR 5.8, CI 1.3-25.2), as were younger women (OR for age (years) 0.9, CI 0.9-1.0), and those with more advanced stage at diagnosis. Conclusions: Black women demonstrated a far higher percentage of distant metastases after diagnosis even when accounting for age and stage. These findings suggest that racial disparities still exist in the development of distant metastases, independent from a late-stage diagnosis. The source of existing disparities needs to be further understood and may be found in surveillance, treatment differences, or follow up.

scholarly journals Delays on Treatment and Associated Factors in a Cohort of Women Diagnosed With Breast Cancer in Rio De Janeiro, Brazil

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 60s-60s
Author(s):  
I.F.d. Silva ◽  
S.D.O. Monteiro ◽  
R.J. Koifman
Keyword(s):  
Breast Cancer ◽  
Developing Countries ◽  
Late Stage ◽  
College Education ◽  
Treatment Delay ◽  
Medical Attention ◽  
Time Interval ◽  
Histopathological Diagnosis ◽  
Stage At Diagnosis ◽  
Negatively Associated

Background: The majority of breast cancer death occurs in developing countries. Mortality reductions achieved in the last decades in developed countries have not been reached in developing countries mainly because of a lack of access to early medical attention and delays on treatment. There are very few research studies on the reasons behind delayed medical attention for breast cancer in women in developing countries. Aim: To estimate the treatment delay, and associated factors, among women diagnosed with breast cancer treated on the National Cancer Institute in Rio de Janeiro, Brazil. Methods: A retrospective study on a cohort of 3220 women newly diagnosed with breast cancer between 2011 and 2013 was accomplished. Times from diagnose to treatment initiation were analyzed according to the Brazilian law for cancer patient treatment (≤ 60 > days). Association between sociodemographic, life style, clinical and treatment variables, and delays on treatment were estimated using X2-test and logistic regression model, with 95% confidential interval. Results: Over 50% of women was 50-69 years old, white (50.5%), presented early stage at diagnosis (63.8%), and refereed from public health service (76.9%). From those who had a histopathological diagnosis on the first visit at NCI (N=2,554), median time from diagnose to 1st treatment was 108 days, varying from 97 days (stage T0-2N>1-X/T3-4N0/X) to 133 days (stage Tis). Among those, prevalence of treatment delay was 89.1%; time interval > 30 days from diagnosis and 1st visit at NCI (OR=29.84; CI: 19.80-44.97) and age (50-69: OR=1.61; CI: 1.24-2.11, ≥70 years: OR=1.91; CI: 1.27-2.89) were statistically associated with treatment delay; while high education (OR=0.31; CI: 0.13-0.73) and late stage at diagnosis (OR=0.63; CI: 0.49-0.80) were negatively associate with treatment delay. Among those who arrived without diagnosis (n=666), prevalence of treatment delay was 34.7%. Considering the whole cohort (N=3220) age ≥70 years old (OR=1.42; 1.04-1.94), living outside Rio city (OR=1.53; 1.26-1.87), and chemotherapy (OR=1.44; 1.06-1.95) were positively associated with delay; while college education (OR=0.73; 0.57-0.94) and late stage (OR=0.71; 0.53-0.96) were negatively associated with treatment delay. Conclusion: Increased breast cancer treatment delay was observed among women who arrived with histopathological diagnosis. Time interval from diagnosis on the 1st visit at cancer center was the main factor associated to treatment delay, followed by old age; while high education level and late stage at diagnosis were negatively associated with treatment delays. Considering the whole cohort, old age, living outside Rio and chemotherapy were positively associated to delays on treatment, while college education level and late stage were negatively associated with treatment delay.

Breast Cancer: Factors Associated With Stage at Diagnosis in Black and White Women

1993 ◽  
Vol 85 (14) ◽  
pp. 1129-1137 ◽  
Author(s):  
C. P. Hunter ◽  
C. K. Redmond ◽  
V. W. Chen ◽  
D. F. Austin ◽  
R. S. Greenberg ◽  
...  
Keyword(s):  
Breast Cancer ◽  
White Women ◽  
Stage At Diagnosis ◽  
Factors Associated ◽  
Black And White

Cancer screening utilization in patients diagnosed with cancer types with and without recommended screening modalities.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10557-10557
Author(s):  
Ariella Cohain ◽  
Christine Hathaway ◽  
Mudit Gupta ◽  
Braxton Lagerman ◽  
Yali Li ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cancer Screening ◽  
Cancer Patients ◽  
Late Stage ◽  
Screening Methods ◽  
Stage At Diagnosis ◽  
Tumor Registry ◽  
Late Stage Diagnosis ◽  
Screening Adherence ◽  
Cancer Types

10557 Background: Several studies have shown screening methods can detect cancer at earlier stages and improve cancer prognosis; however, only four cancer types (breast, colorectal, cervical, and lung) currently have screening methods recommended by the United States Preventive Services Taskforce (USPSTF). In 2021, these four cancers are expected to make up roughly 40% of new cases and cancer deaths, meaning that the majority of cancer deaths will be associated with cancer types lacking recommended screening. We sought to characterize patients who were diagnosed with cancer types with and without recommended screening modalities to demonstrate the gaps in screening faced by the majority of cancers today. Methods: The Geisinger Health System (GHS) Phenomics Initiative Database (PIDB) provides deidentified data from electronic health, billing, and imaging records, and a tumor registry. PIDB was used to identify patients aged 50 to 76 who had cancers diagnosed between 2008 and 2020 and a record of USPSTF-recommended cancer screenings within GHS prior to diagnosis. Analysis focused on patients who received care at GHS during their screening-eligible intervals. Results: Between 2008 and 2020, 13,347 incident invasive cancers were identified in the GHS tumor registry. Of these, 40% (N = 5,331) were cancer types with a recommended screening modality. 57% of these cases (N = 3,039; 23% of all incident cancers) occurred in patients who underwent screening in the interval preceding diagnosis. Screening adherence was significantly associated with stage at diagnosis; patients who were not screened for their diagnosed cancer were more than twice as likely to have a late-stage diagnosis as compared with patients who received screening (multivariate ordinal logistic regression, OR = 2.16, p < 0.001). Patterns of screening adherence in this population are complex; however, 57% of these patients had received screening for a different cancer type. The majority of incident cancers were of those types with no recommended screening modality (N = 8,016; 60% of all incident cancers). Of these, most (N = 6,252; 78%) had been screened for at least one of breast, lung, colon, or cervical cancer and nearly half (N = 3,607; 45%) were current for all guideline-recommended screenings. Not surprisingly, stage at diagnosis was not associated with adherence to any or all screening modalities (multivariate ordinal logistic regression, p = 0.11 and p = 0.45). Conclusions: The majority (79%) of individuals diagnosed with cancer had a history of adherence to at least one screening recommendation. Out of all cancer patients, only 23% were screened specifically for the cancer with which they were subsequently diagnosed, a group that is associated with a lower odds of a late-stage diagnosis. This suggests that the majority of cancer patients who underwent any cancer screening did not benefit from earlier stage diagnosis.

scholarly journals 44P Obesity is associated with a late-stage diagnosis in triple-negative breast cancer

2020 ◽  
Vol 31 ◽  
pp. S31
Author(s):  
A. Aranda-Gutierrez ◽  
A.S. Ferrigno ◽  
M. Moncada-Madrazo ◽  
A. Gomez-Picos ◽  
C. De la Garza-Ramos ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Late Stage ◽  
Triple Negative ◽  
Late Stage Diagnosis

scholarly journals Analysis of Delays in Breast Cancer Treatment and Late-Stage Diagnosis in Kazakhstan By Using Electronic Cancer Registry Data

2017 ◽  
Vol 3 (2_suppl) ◽  
pp. 15s-15s
Author(s):  
Askar S. Chukmaitov ◽  
Umaporn Sianghpoe ◽  
Dilyara R. Kaidarova ◽  
Snnar T. Talaeva ◽  
Vanessa B. Sheppard ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Late Stage ◽  
Tertiary Care ◽  
Cancer Center ◽  
Case Mix ◽  
Cancer Centers ◽  
Delayed Treatment ◽  
Patient Demographics ◽  
Center Region ◽  
Late Stage Diagnosis

Abstract 27 Background: Although Kazakhstan (KZ) has made significant investments to improve population health, high cancer rates persist, with breast cancer as the most prevalent. We assessed factors that contribute to delays in treatment and late staging for patients with breast cancer. Methods: A retrospective follow-up study design was used. By using 2014 registry data, we identified 4,248 patients with breast cancer who were treated at cancer centers in the 16 KZ regions. Patients with delays in treatment as a result of medical errors and other reasons were identified. We used logistic regression to estimate associations of delays with patient demographics, occupation, and cancer center region; and associations of late-stage (III and IV) cancer diagnosis with delays in treatment while controlling for patient demographics, occupation, and cancer center region. Results: Approximately 9% (n = 378) of patients experienced delayed treatment. Older and Russian patients as well as those treated in regions further away from Almaty City had significantly higher adjusted risk of delayed treatment. However, risk of late-stage diagnosis was greater for patients who were treated in Almaty City and for those who were Russian, unemployed, or who had delayed treatment. Conclusion: The main driver of delayed treatment was cancer center region. Patients who were treated in Almaty City, where the national cancer research and treatment center is located, had fewer delays in treatment but a higher likelihood of late-stage diagnosis, likely as a result of referrals of sicker patients from neighboring regions. These findings suggest that referrals to new tertiary care centers being developed in KZ may reduce treatment delays but affect facility case mix. Future research will examine the role played by distance to cancer centers in access to specialty care and whether tertiary care is associated with improved outcomes conditional on case mix. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.

scholarly journals The Incidence of Breast Cancer among Disabled Kansans with Medicare

2015 ◽  
Vol 8 (3) ◽  
pp. 93-100
Author(s):  
Austin R Rogers ◽  
Sue-Min Lai ◽  
John Keighley ◽  
Jessica Jungk
Keyword(s):  
Breast Cancer ◽  
Cancer Incidence ◽  
Late Stage ◽  
Breast Cancer Incidence ◽  
Stage At Diagnosis ◽  
Medicare Beneficiaries ◽  
Cancer Registry Data ◽  
Significant Difference ◽  
Disability Status ◽  
Adjusted Incidence

BACKGROUND: Breast cancer disparities by disability status are poorly understood. While previous studies have shown increased odds of late stage at diagnosis, it is unclear whether the incidence of breast cancer varies by disability status. METHODS: To assess cancer incidence and stage at diagnosis among disabled and nondisabled Medicare beneficiaries in Kansas, a retrospective cohort study was conducted using linked Medicare enrollment and Kansas Cancer Registry data from 2007 to 2009. Disability status was determined by the indicator for the original reason for Medicare eligibility. RESULTS: Among the 651,337 Medicare beneficiaries included in the cohort, there were 2,384 cases of breast cancer. The age-adjusted incidence was 313 per 100,000 among female beneficiaries with disabilities and 369 per 100,000 among nondisabled female beneficiaries. The adjusted incidence rate ratio was 0.93 (95% CI 0.73-1.18). When assessing stage at diagnosis, there was no difference in the odds of late stage at diagnosis by disability status (OR = 1.02; 95% CI 0.68-1.50). CONCLUSION: No significant difference in incidence or stage at diagnosis was identified among this cohort. The use of Medicare eligibility to define disability status presented a number of limitations. Future studies should seek alternate definitions of disability to assess disparities in breast cancer incidence, including definitions using Medicare claims data.

scholarly journals Trends in Breast Cancer Incidence Rates by Age and Stage at Diagnosis in Gharbiah, Egypt, over 10 Years (1999–2008)

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Kelly A. Hirko ◽  
Amr S. Soliman ◽  
Ahmed Hablas ◽  
Ibrahim A. Seifeldin ◽  
Mohamed Ramadan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Incidence ◽  
Breast Cancer Incidence ◽  
Incidence Rates ◽  
Stage At Diagnosis ◽  
Treatment Needs ◽  
Annual Percent Change ◽  
Cancer Occurrence ◽  
Health Transitions ◽  
Cancer Incidence Rates

Background. This study was undertaken to evaluate trends in breast cancer incidence in Egypt from 1999 to 2008 and to make projections for breast cancer occurrence for the years 2009–2015.Patients and Methods. We utilized joinpoint regression and average annual percent change (AAPC) measures with 95% confidence intervals (CI) to describe the trends in breast cancer incidence rates from the Gharbiah Cancer Registry by age and stage at diagnosis and to estimate expected breast cancer caseloads for 2009–2015.Results. From 1999 to 2008, the AAPC in breast cancer incidence rates in Gharbiah significantly increased among women 50 years and older and among localized tumors (AAPC %, 95% CI, 3.1% to 8.0%). Our results predict a significant increase in breast cancer caseloads from 2009 to 2015 among women aged 30–39 (AAPC %, 95% CI, 0.9% to 1.1%) and among women aged 40–49 years (AAPC %, 95% CI, 1.0% to 2.6%).Conclusion. These results have important implications for allocating limited resources, managing treatment needs, and exploring the consequences of prior interventions and/or changing risk factors in Egypt and other developing countries at the same stages of demographic and health transitions.

Sign in / Sign up

Export Citation Format

Share Document