Challenges to the early diagnosis and treatment of breast cancer in developing countries

doi:10.5306/wjco.v5.i3.465

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World Journal of Clinical Oncology

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World J Clin Oncol. Aug 10, 2014; 5(3): 465-477
Published online Aug 10, 2014. doi: 10.5306/wjco.v5.i3.465

Table 3 Time intervals for breast cancer care-findings from the literature

Country (region)	Year	n	Total interval			Patient interval		Provider/system intervals
Country (region)	Year	n	Definition	Median/mean¹	> 3 mo(%)	Median/mean¹	> 3 mo(%)	Reportedinterval	Definition	Median/mean¹	> 3 mo(%)
High-income countries
Canada (Quebec)[105]	1992-1998	29606	-	-	-	-	-	Treatment	1^st diagnostic study to surgery.	42 d	17.1
Canada[106]	1996	4465	-	-	-	-	-	Diagnosis	Abnormal screening to diagnosis	31 d	-
France[30]	2003	1494	1^st abnormal screening to treatment start	34 d	-	-	-	Diagnosis	Abnormal screening to diagnosis	7 d	-
France[30]	2003	1494	1^st abnormal screening to treatment start	34 d	-	-	-	Treatment	Diagnosis to treatment start	27 d	-
Germany (Saarland)[11,107,108]	1996-1998	380	Symptom discovery or abnormal screening to diagnosis	-	26.1	16 d	17.4	Provider	1^st consultation to treatment start	15 d	11.0
Italy (Campania)[56]	1998-1999	644	Symptom discovery to surgery	-	35	-	20	-	1^st medical consultation to hospital admission	-	11
Italy (Campania and Apulia)[109]	2004-2006	959	-	-	-	-	-	Diagnosis	1^st consultation to diagnosis	-	60

Nether-lands[110]	1996-2002	1503	-	-	-	-	-	Diagnosis	Screening to diagnosis	-	6.5
North Ireland[91]	2006	759	-	-	-	-	-	Treatment	Diagnosis to treatment start	15 d	-
Scotland[111]	2005-2007	1250	-	-	-	7 d	-	Referral	1^st consultation to referral	1 d	-
Scotland[111]	2005-2007	1250	-	-	-	7 d	-	Specialist	Referral by GP to 1^st consultation by specialist	18 d	-
Spain (Catalonia)[112]	2001-2002	266	-	-	-	-	-	Treatment	Diagnosis to treatment start	35 d	-
United Kingdom[113]	1999-2000	25627	Symptom discovery to diagnosis	30 d	-	9 d	-	-	GP referral to diagnosis	11 d	-
United States[31]	1991-1995	1659	Abnormal screening to treatment start	48 d	22.9	-	-	Diagnosis	1^st abnormal screening to diagnosis	32 d	-
United States[31]	1991-1995	1659	Abnormal screening to treatment start	48 d	22.9	-	-	Treatment	Diagnosis to treatment start.	10 d	-
United States[54]	1995-2005	246957	-	-	-	-	-	Treatment	Diagnosis to treatment start	23 d	-
United States (Califor-nia)[114]	2003-2005	921 low income women	Symptom discovery to biopsy		39	-	-	-	-	-	-
United States (North Carolina)[115]	2000-2002	1786	-	-	-	-	-	Treatment	Diagnosis to treatment start	22 d	-
Middle-income countries:
Brazil (Brasilia)[25]	2010	250	Symptom discovery to treatment	7.5 mo	88.8	-	29.9	Provider	1^st consultation to treatment start	-	77.6
Brazil (Rio)[24]	2004	104	Symptom discovery to diagnosis	8 mo	-	1 mo	-	Diagnosis	1^st consultation to diagnosis	6.5 mo	80
Bulgaria[23]	2011	448	Symptom discovery to treatment	3.9 mo¹	-	1.2 mo¹	-	Provider	1^st consultation to treatment start	3.1 mo¹	-
Colombia[95,116]	2006-2007	852	-	-	-	-	20.3	Provider	1^st consultation to treatment start	4.5 mo	31
Croatia[23]	2011	167	Symptom discovery to treatment	3.4 mo¹	-	1.2 mo¹		Provider	1^st consultation to treatment start	2.6 mo¹	-
Egypt[29]	2010	163	-	-	-	2.7 mo	-	-	1^st consultation to hospital arrival	18 d	-
Ethiopia[117]	2008	69	-	-	-	18 mo¹	-	-	-	-	-
Haiti[118]	2012	90	-	-	-	1 wk	42%	-	-	-	-
Hungary[23]	2011	167	Symptom discovery to treatment	4.0 mo¹	-	24 d¹	-	Provider	1^st consultation to treatment start	3.6 mo¹	-
India[23]	2011	207	Symptom discovery to treatment	7.4 mo¹	-	1.5 mo¹	-	Provider	1^st consultation to treatment start	6.2 mo¹	-
Iran[28]	2000-2001	200	-	-	-	3 mo	42.5	-	-	-	-
Latvia[23]	2011	111	Symptom discovery to treatment	4.4 mo¹	-	1.5 mo¹	-	Provider	1^st consultation to treatment start	3.3 mo¹	-
Libya[22]	2008-2009	200	Symptom discovery to diagnosis	-	70.0	-	54.5	-	-	-	-
Lithuania[23]	2011	368	Symptom discovery to treatment	3.0 mo¹	-	1.2 mo¹	-	Provider	1^st consultation to treatment start	2.1 mo¹	-
Malaysia[26]	2005-2007	328	Symptom discovery to diagnosis	5.5 mo	72.6	2 mo	43.3	-	-	-	-
Mexico[34]	2008	32	Symptom discovery to treatment start	7.5 mo		10 d		Diagnosis	1^st consultation to diagnosis	2.8 mo
Mexico[27]	2010-2011	384	Abnormal mammogram or symptom discovery to treatment start	7.8 mo	90.0	11 d	20.6	Provider	1^st consultation to treatment start	4.7 mo	73.7
Nigeria[103]	2009-2010	201	-	-	-	-	81	-	-	-	-
Poland[23]	2011	557	Symptom discovery to treatment	2.9 mo¹	-	25 d¹	-	Provider	1^st consultation to treatment start	2.4 mo¹	-
Romania[23]	2011	271	Symptom discovery to treatment	6.4 mo¹	-	1.5 mo¹	-	Provider	1^st consultation to treatment start	7.4 mo¹	-
Russia[23]	2011	718	Symptom discovery to treatment	3.9 mo¹	-	1.2 mo¹	-	Provider	1^st consultation to treatment start	3.1 mo¹	-
Slovakia[23]	2011	154	Symptom discovery to treatment	3.3 mo¹	-	1.0 mo¹	-	Provider	1^st consultation to treatment start	2.7 mo¹	-
Serbia[23]	2011	663	Symptom discovery to treatment	3.2 mo¹	-	1.1 mo¹	-	Provider	1^st consultation to treatment start	2.3 mo¹	-
Thailand[35]	1994-1996	94	-	-	-	1 mo	26.6	Provider	1^st medical consultation to hospital admission	1 mo	24.4
Thailand[36]	2009	109	-	-	-	12 d	17.0	Provider	1^st consultation to treatment start	21 d	42.0
Turkey[23]	2011	694	Symptom discovery to treatment	3.4 mo¹	-	1.2 mo¹	-	Provider	1^st consultation to treatment start	2.6 mo¹	-

¹These correspond to mean intervals, instead of medians. Patient interval is not defined in the table because studies coincide in the accepted definition: symptom discovery or abnormal screening to first medical consultation.

Citation: Unger-Saldaña K. Challenges to the early diagnosis and treatment of breast cancer in developing countries. World J Clin Oncol 2014; 5(3): 465-477
URL: https://www.wjgnet.com/2218-4333/full/v5/i3/465.htm
DOI: https://dx.doi.org/10.5306/wjco.v5.i3.465