Long travel distance for health care and poor adherence to breast cancer screening programs as predictors of patient delay

Patient delay (PD) is a leading cause of advanced stage of disease and poor prognosis among Brazilian breast cancer patients. The present study addressed socio-demographic variables and their impact on PD. Odds Ratios (OR) and Confidence Intervals (CI) were determined using regression analysis. Data of 103 breast cancer patients were obtained from medical records and interviews. All patients detected first symptoms of breast cancer on their own. On average, patients were seeking for medical help 67.5 (s= 124.1) days after recognition of symptoms. More than 60 days between recognition of symptoms and first medical visit was defined as PD in 33 (32.0%) cases. Low and intermediate educational level increased chance of PD, 1.22 (95%CI: 0.33-4.48) and 1.92 (95%CI: 0.53-7.00) fold. Having no stable relationship increased chance of PD 2.04 (95%CI: 0.88-4.73) fold. Patients without a private health insurance had a 1.90 (95%CI: 0.49-7.32) increased chance of PD. Women, who had not at all, or rarely performed medical visits at their own living place, had a 6.25 (0.76-51.33) increased chance of PD (p< 0.05). Patients who had never performed mammography and CBE had a 1.78 (0.57-5.53) and 1.47 (0.44-4.89) increased chance of PD. Not having a health service at the own living place was the most prominent causal factor of PD. As tumours of patients were not discovered during medical exams, the negative association between adherence to prevention programs and PD, points to additional attitudes of participating women that reduced treatment delay.