Time to diagnosis and treatment of breast cancer: results from the National Breast and Cervical Cancer Early Detection Program, 1991-1995.

OBJECTIVES This study examined times to diagnosis and treatment for medically underserved women screened for breast cancer. METHODS Intervals from first positive screening test to diagnosis to initiation of treatment were determined for 1659 women 40 years and older diagnosed with breast cancer. RESULTS Women with abnormal mammograms had shorter diagnostic intervals than women with abnormal clinical breast examinations and normal mammograms. Women with self-reported breast symptoms had shorter diagnostic intervals than asymptomatic women. Diagnostic intervals were less than 60 days in 78% of cases. Treatment intervals were generally 2 weeks or less. CONCLUSIONS Most women diagnosed with breast cancer were followed up in a timely manner after screening. Further investigation is needed to identify and then address factors associated with longer diagnostic and treatment intervals to maximize the benefits of early detection.

[1]  K. Midthjell,et al.  Is questionnaire information valid in the study of a chronic disease such as diabetes? The Nord-Trøndelag diabetes study. , 1992, Journal of epidemiology and community health.

[2]  J. Ivy.  Role of Exercise Training in the Prevention and Treatment of Insulin Resistance and Non-Insulin-Dependent Diabetes Mellitus , 1997, Sports medicine.

[3]  K. Patrick,et al.  Physical Activity and Public Health: A Recommendation From the Centers for Disease Control and Prevention and the American College of Sports Medicine , 1995 .

[4]  R. Paffenbarger,et al.  Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. , 1991, The New England journal of medicine.

[5]  S Edeiken,et al.  Mammography and palpable cancer of the breast , 1988, Cancer.

[6]  Daniel L. McGee,et al.  Determinants of incident non-insulin-dependent diabetes mellitus among blacks and whites in a national sample. The NHANES I Epidemiologic Follow-up Study. , 1993, American journal of epidemiology.

[7]  N. Lee,et al.  The National Breast and Cervical Cancer Early Detection Program: a comprehensive public health response to two major health issues for women. , 1996, Journal of public health management and practice : JPHMP.

[8]  S. Haffner,et al.  Sex Difference in Lifestyle Factors Predictive of Diabetes in Mexican-Americans , 1995, Diabetes Care.

[9]  T. Sellers,et al.  Mortality and cancer rates in nonrespondents to a prospective study of older women: 5-year follow-up. , 1994, American journal of epidemiology.

[10]  G. Dalsky,et al.  Insulin action and secretion in endurance-trained and untrained humans. , 1987, Journal of applied physiology.

[11]  J. Holloszy,et al.  Effects of exercise on glucose tolerance and insulin resistance. Brief review and some preliminary results. , 2009, Acta medica Scandinavica. Supplementum.

[12]  J F Sallis,et al.  Compendium of physical activities: classification of energy costs of human physical activities. , 1993, Medicine and science in sports and exercise.

[13]  K. Kerlikowske,et al.  Racial differences in timeliness of follow‐up after abnormal screening mammography , 1996, Cancer.

[14]  M. Baum,et al.  Delay in presentation of women with breast disease. , 1976, Clinical oncology.

[15]  W C Willett,et al.  A prospective study of exercise and incidence of diabetes among US male physicians. , 1992, JAMA.

[16]  R. Borovik,et al.  Factors affecting delay in diagnosis of breast cancer: relationship of delay to stage of disease. , 1986, Israel journal of medical sciences.

[17]  R. Priore,et al.  Delay, stage of disease and survival from breast cancer. , 1979, Journal of chronic diseases.

[18]  Barbara L. Smith,et al.  Evaluation of common breast problems: Guidance for primary care providers , 1998, CA: a cancer journal for clinicians.

[19]  J. Manson,et al.  Physical activity and incidence of non-insulin-dependent diabetes mellitus in women , 1991, The Lancet.

[20]  L. Northouse,et al.  Emotional Distress Reported By Women and Husbands Prior to a Breast Biopsy , 1995, Nursing research.

[21]  T. Rönnemaa,et al.  A controlled randomized study on the effect of long-term physical exercise on the metabolic control in type 2 diabetic patients. , 2009, Acta medica Scandinavica.

[22]  K. Helzlsouer,et al.  Delay in breast cancer: a review of the literature. , 1992, Public health reviews.

[23]  P. Langenberg,et al.  Breast Imaging Reporting and Data System: inter- and intraobserver variability in feature analysis and final assessment. , 2000, AJR. American journal of roentgenology.

[24]  M. Vessey,et al.  Delay in treatment for breast cancer , 1980 .

[25]  P. Whincup,et al.  Prospective study of risk factors for development of non-insulin dependent diabetes in middle aged British men , 1995, BMJ.

[26]  T. Lakka,et al.  Moderately intense physical activities and high levels of cardiorespiratory fitness reduce the risk of non-insulin-dependent diabetes mellitus in middle-aged men. , 1996, Archives of internal medicine.

[27]  A. Folsom,et al.  Central adiposity and increased risk of coronary artery disease mortality in older women. , 1993, Annals of epidemiology.

[28]  S. Shapiro,et al.  System delay in breast cancer in whites and blacks. , 1995, American journal of epidemiology.

[29]  Physical activity and mortality in postmenopausal women. , 1997, JAMA.

[30]  B. Kohler,et al.  The Relation between Health Insurance Coverage and Clinical Outcomes among Women with Breast Cancer , 1993 .

[31]  N. Facione.  Delay versus help seeking for breast cancer symptoms: a critical review of the literature on patient and provider delay. , 1993, Social science & medicine.

[32]  J. Tuomilehto,et al.  Abdominal Obesity and Physical Inactivity as Risk Factors for NIDDM and Impaired Glucose Tolerance in Indian, Creole, and Chinese Mauritians , 1991, Diabetes Care.

[33]  J. Kampert,et al.  The Association between Cardiorespiratory Fitness and Impaired Fasting Glucose and Type 2 Diabetes Mellitus in Men , 1999, Annals of Internal Medicine.

[34]  Alec M. Gallup,et al.  The Gallup poll : public opinion , 1972 .

[35]  J. Cerhan,et al.  Body fat distribution and 5-year risk of death in older women. , 1993, JAMA.

[36]  H. King,et al.  Risk factors for diabetes in three Pacific populations. , 1984, American journal of epidemiology.

[37]  R N Bergman,et al.  Intensity and amount of physical activity in relation to insulin sensitivity: the Insulin Resistance Atherosclerosis Study. , 1998, JAMA.

[38]  A. Folsom,et al.  Increase in fasting insulin and glucose over seven years with increasing weight and inactivity of young adults. The CARDIA Study. Coronary Artery Risk Development in Young Adults. , 1996, American journal of epidemiology.

[39]  W. Waters,et al.  Delay in the presentation of breast symptoms for consultant investigation , 1981 .

[40]  L. Caplan.  Patient delay in seeking help for potential breast cancer. , 1995, Public health reviews.

[41]  A. Giuliano,et al.  Delayed diagnosis of breast cancer as a result of normal mammograms. , 1983, Archives of surgery.

[42]  Johnson Jh.  THE GALLUP POLL. , 1965 .

[43]  D. Thomas,et al.  Delay from symptom to diagnosis and treatment of breast cancer in Washington State and British Columbia. , 1993, Medical care.

[44]  D. May,et al.  The National Breast and Cervical Cancer Early Detection Program: report on the first 4 years of mammography provided to medically underserved women. , 1998, AJR. American journal of roentgenology.

[45]  A. Folsom,et al.  Increased incidence of diabetes mellitus in relation to abdominal adiposity in older women. , 1991, Journal of clinical epidemiology.

[46]  Paffenbarger Rs,et al.  Physical activity in the prevention of non-insulin-dependent diabetes mellitus. , 1997 .

[47]  G. Lesnick.  Detection of breast cancer in young women. , 1977, JAMA.

[48]  B. Lim,et al.  Analysis of survival and recurrence vs. patient and doctor delay in treatment of breast cancer , 1975, Cancer.

[49]  Melvin Prince,et al.  The Diabetes Prevention Program. Design and methods for a clinical trial in the prevention of type 2 diabetes. , 1999, Diabetes care.

[50]  K. Yano,et al.  Physical activity and incidence of diabetes: the Honolulu Heart Program. , 1995, American journal of epidemiology.