Delays in diagnosis and treatment of breast cancer: A multinational analysis

Jacek Jassem, Vahit Ozmen, Florin Bacanu, Monika Drobniene, Janis Eglitis, Kuntegowdanahalli C. Lakshmaiah, Zsuzsanna Kahan, Jozef Mardiak, Tadeusz Pieńkowski, Tatiana Semiglazova, Ljiljana Stamatovic, Constanta Timcheva, Suzana Vasovic, Damir Vrbanec, Piotr Zaborek

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52 Citations (Scopus)


Background: Reducing treatment delay improves outcomes in breast cancer. The aim of this study was to determine factors influencing patient- and system-related delays in commencing breast cancer treatment in different countries. Methods: A total of 6588 female breast cancer patients from 12 countries were surveyed. Total delay time was determined as the sum of the patient-related delay time (time between onset of the first symptoms and the first medical visit) and system-related delay time (time between the first medical visit and the start of therapy). Results: The average patient-related delay time and total delay time were 4.7 (range: 3.4-6.2) weeks and 14.4 (range: 11.5-29.4) weeks, respectively. Longer patient-related delay times were associated with distrust and disregard, and shorter patient-related delay times were associated with fear of breast cancer, practicing self-examination, higher education level, being employed, having support from friends and family and living in big cities. The average system-related delay time was 11.1 (range: 8.3-24.7) weeks. Cancer diagnosis made by an oncologist versus another physician, higher education level, older age, family history of female cancers and having a breast lump as the first cancer sign were associated with shorter system-related delay times. Longer patient-related delay times and higher levels of distrust and disregard were predictors of longer system-related delay times. Conclusions: The delay in diagnosis and treatment of breast cancer remains a serious problem. Several psychological and behavioural patient attributes strongly determine both patient-related delay time and system-related delay time, but their strength is different in particular countries.

Original languageEnglish
Pages (from-to)761-767
Number of pages7
JournalEuropean journal of public health
Issue number5
Publication statusPublished - Oct 1 2013


ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Jassem, J., Ozmen, V., Bacanu, F., Drobniene, M., Eglitis, J., Lakshmaiah, K. C., Kahan, Z., Mardiak, J., Pieńkowski, T., Semiglazova, T., Stamatovic, L., Timcheva, C., Vasovic, S., Vrbanec, D., & Zaborek, P. (2013). Delays in diagnosis and treatment of breast cancer: A multinational analysis. European journal of public health, 24(5), 761-767.