부산대학교 도서관

Purpose: Breast cancer is the first most common type of cancer among women worldwide. Delay in diagnosis and treatment may lead to late-stage and poor prognosis. Measuring waiting times is a good indicator of the quality and performance of cancer care. This study aims at investigating the factors associated with delayed diagnosis and treatment of breast cancer in Casablanca.Methods: This is a cross-sectional study with consecutive recruitment from January to June 2018 of patients with breast cancer in the University hospital center Ibn Rochd of Casablanca and the private center Ryad of Casablanca. The target population consisted of women newly diagnosed with breast cancer. Women who had secondary breast cancer or refused to answer the questionnaire were excluded. The information was collected by trained Ph.D. student via a structured questionnaire based on the patients’ medical records. Ordinal logistic regressions, stratified on medical care type (public and private), were used to identify factors associated with a longer delay: Patient Delay (PD), Diagnosis Delay (DD), and Health System Delay (HSD). The p-values < 0.05 were considered statistically significant. Statistical analyses were performed using R statistical analysis software version 4.0.5. We used quartiles to define long delays. A longer PD was defined as a delay ≥ 35 days, a longer DD as a delay ≥ 16 days and a longer HSD as a delay ≥ 48 days.Results: The total study population included 300 women with an average age of 52 ± 11 years. Fifty-one percent (51.7%) are diagnosed at a late stage. For women who received public care, the factors associated with diagnostic delay were marriage (aOR = 1.66 [0.92–3.01]) and consulting once or twice before diagnosis (aOR = 2.86 [1.31–6.24]). For women who received private care, delay in treatment was higher for women who were housewives (aOR = 3.94 [1.05–14.75]).Conclusion: Our study showed that factors associated with diagnosis delay were marriage and consulting once or twice before diagnosis in public care, and with treatment delay was higher for women who were housewives in private care which leads us to conclude that population-wide awareness and education programs are neededto improve the recognition of symptoms and promote prompt healthcare seeking to improve early diagnosis and survival. The ideas highlighted in this study can be used to provide recommendations for areas of improved cancer education as well as potential prevention and screening programs. Additional studies are needed to determine if similar differential delays exist in other regions of Morocco.