Diagnostic pathways for breast cancer in 10 International Cancer Benchmarking Partnership (ICBP) jurisdictions: an international comparative cohort study based on questionnaire and registry data
Objectives A growing body of evidence suggests longer time between symptom onset and start of treatment affects breast cancer prognosis. To explore this association, the International Cancer Benchmarking Partnership Module 4 examined differences in breast cancer diagnostic pathways in 10 jurisdictio...
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BMJ Publishing Group
2022-12-01
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| Online Access: | https://bmjopen.bmj.com/content/12/12/e059669.full |
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| author | David Weller Usha Menon Alina Zalounina Falborg Henry Jensen Andriana Barisic Anne Kari Knudsen David H Brewster Victoria Cairnduff Eva Grunfeld Elizabeth Harland Mats Lambe Rebecca-Jane Law Yulan Lin Martin Malmberg Donna Turner Richard D Neal Victoria White Samantha Harrison Peter Vedsted Una MacLeod Conan Donnelly Anna Gavin Jon Emery Oliver Bucher Jatinderpal Kalsi Chantelle Anandan Evangelia Ourania Fourkala Therese Kearney Marie-Louise Essink-Bot Sigrun Saur Almberg Breann Hawryluk Jacqueline Kelly Jackie Boylan Jan Willem Coebergh David Brewster Stefan Bergström Victoria Hammersley Rebecca Bergin Alina Zalounina Falborg Andriana Barisi Kerry Moore Maria Rejmyr Davis |
| author_facet | David Weller Usha Menon Alina Zalounina Falborg Henry Jensen Andriana Barisic Anne Kari Knudsen David H Brewster Victoria Cairnduff Eva Grunfeld Elizabeth Harland Mats Lambe Rebecca-Jane Law Yulan Lin Martin Malmberg Donna Turner Richard D Neal Victoria White Samantha Harrison Peter Vedsted Una MacLeod Conan Donnelly Anna Gavin Jon Emery Oliver Bucher Jatinderpal Kalsi Chantelle Anandan Evangelia Ourania Fourkala Therese Kearney Marie-Louise Essink-Bot Sigrun Saur Almberg Breann Hawryluk Jacqueline Kelly Jackie Boylan Jan Willem Coebergh David Brewster Stefan Bergström Victoria Hammersley Rebecca Bergin Alina Zalounina Falborg Andriana Barisi Kerry Moore Maria Rejmyr Davis |
| collection | DOAJ |
| description | Objectives A growing body of evidence suggests longer time between symptom onset and start of treatment affects breast cancer prognosis. To explore this association, the International Cancer Benchmarking Partnership Module 4 examined differences in breast cancer diagnostic pathways in 10 jurisdictions across Australia, Canada, Denmark, Norway, Sweden and the UK.Setting Primary care in 10 jurisdictions.Participant Data were collated from 3471 women aged >40 diagnosed for the first time with breast cancer and surveyed between 2013 and 2015. Data were supplemented by feedback from their primary care physicians (PCPs), cancer treatment specialists and available registry data.Primary and secondary outcome measures Patient, primary care, diagnostic and treatment intervals.Results Overall, 56% of women reported symptoms to primary care, with 66% first noticing lumps or breast changes. PCPs reported 77% presented with symptoms, of whom 81% were urgently referred with suspicion of cancer (ranging from 62% to 92%; Norway and Victoria). Ranges for median patient, primary care and diagnostic intervals (days) for symptomatic patients were 3–29 (Denmark and Sweden), 0–20 (seven jurisdictions and Ontario) and 8–29 (Denmark and Wales). Ranges for median treatment and total intervals (days) for all patients were 15–39 (Norway, Victoria and Manitoba) and 4–78 days (Sweden, Victoria and Ontario). The 10% longest waits ranged between 101 and 209 days (Sweden and Ontario).Conclusions Large international differences in breast cancer diagnostic pathways exist, suggesting some jurisdictions develop more effective strategies to optimise pathways and reduce time intervals. Targeted awareness interventions could also facilitate more timely diagnosis of breast cancer. |
| format | Article |
| id | doaj-art-1ee50e92f7ca466cb68f01ac161a3624 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-1ee50e92f7ca466cb68f01ac161a36242025-02-10T15:35:09ZengBMJ Publishing GroupBMJ Open2044-60552022-12-01121210.1136/bmjopen-2021-059669Diagnostic pathways for breast cancer in 10 International Cancer Benchmarking Partnership (ICBP) jurisdictions: an international comparative cohort study based on questionnaire and registry data 0David Weller1Usha Menon2Alina Zalounina Falborg3Henry Jensen4Andriana Barisic5Anne Kari KnudsenDavid H BrewsterVictoria CairnduffEva Grunfeld6Elizabeth Harland7Mats Lambe8Rebecca-Jane Law9Yulan Lin10Martin Malmberg11Donna Turner12Richard D Neal13Victoria White14Samantha Harrison15Peter Vedsted16Una MacLeod17Conan DonnellyAnna Gavin18Jon Emery19Oliver BucherJatinderpal Kalsi20Chantelle AnandanEvangelia Ourania FourkalaTherese KearneyMarie-Louise Essink-BotSigrun Saur AlmbergBreann Hawryluk21Jacqueline KellyJackie BoylanJan Willem CoeberghDavid Brewster22Stefan BergströmVictoria HammersleyRebecca Bergin23Alina Zalounina FalborgAndriana BarisiKerry MooreMaria Rejmyr DavisService de Biochimie-Génétique et Inserm U955 équipe 11, Groupe Henri Mondor-Albert Chenevier, APHP, Créteil, FranceGeneral Practice, University of Edinburgh, Edinburgh, UKInstitute of Clinical Trials and Methodology, MRC Clinical Trials Unit at UCL, London, London, UKDepartment of Public Health, Research Unit for General Practice, Aarhus University, Aarhus C, DenmarkDepartment of Public Health, Research Unit for General Practice, Aarhus University, Aarhus C, DenmarkRenal Network, Cancer Care Ontario, Toronto, Ontario, CanadaDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, CanadaDepartment of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, CanadaUniversity Hospital, Regional Cancer Centre of Central Sweden, Uppsala, SwedenNorth Wales Centre for Primary Care Research, Bangor University, Bangor, UKDepartment of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, ChinaDepartment of Oncology, Lund University Hospital, Lund, SwedenPopulation Oncology, Cancer Care Manitoba, Winnipeg, Manitoba, CanadaUniversity of Leeds, Leeds, UK9 Faculty of Health, Deakin University, Burwood, Victoria, AustraliaPolicy and Information, Cancer Research UK, London, UKDepartment of Public Health, Research Unit for General Practice, Aarhus University, Aarhus C, DenmarkUniversity of Hull, Hull, UKN Ireland Cancer Registry, Queen`s University Belfast, Belfast, UK12 General Practice and Primary Care Academic Centre, University of Melbourne, Carlton, Victoria, AustraliaGynaecological Cancer Research Centre, University College London, London, UKPatient Navigation, CancerCare Manitoba, Winnipeg, Manitoba, CanadaScottish Registry, Information Services Division, NHS National Services Scotland, Edinburgh, UKCentre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, AustraliaObjectives A growing body of evidence suggests longer time between symptom onset and start of treatment affects breast cancer prognosis. To explore this association, the International Cancer Benchmarking Partnership Module 4 examined differences in breast cancer diagnostic pathways in 10 jurisdictions across Australia, Canada, Denmark, Norway, Sweden and the UK.Setting Primary care in 10 jurisdictions.Participant Data were collated from 3471 women aged >40 diagnosed for the first time with breast cancer and surveyed between 2013 and 2015. Data were supplemented by feedback from their primary care physicians (PCPs), cancer treatment specialists and available registry data.Primary and secondary outcome measures Patient, primary care, diagnostic and treatment intervals.Results Overall, 56% of women reported symptoms to primary care, with 66% first noticing lumps or breast changes. PCPs reported 77% presented with symptoms, of whom 81% were urgently referred with suspicion of cancer (ranging from 62% to 92%; Norway and Victoria). Ranges for median patient, primary care and diagnostic intervals (days) for symptomatic patients were 3–29 (Denmark and Sweden), 0–20 (seven jurisdictions and Ontario) and 8–29 (Denmark and Wales). Ranges for median treatment and total intervals (days) for all patients were 15–39 (Norway, Victoria and Manitoba) and 4–78 days (Sweden, Victoria and Ontario). The 10% longest waits ranged between 101 and 209 days (Sweden and Ontario).Conclusions Large international differences in breast cancer diagnostic pathways exist, suggesting some jurisdictions develop more effective strategies to optimise pathways and reduce time intervals. Targeted awareness interventions could also facilitate more timely diagnosis of breast cancer.https://bmjopen.bmj.com/content/12/12/e059669.full |
| spellingShingle | David Weller Usha Menon Alina Zalounina Falborg Henry Jensen Andriana Barisic Anne Kari Knudsen David H Brewster Victoria Cairnduff Eva Grunfeld Elizabeth Harland Mats Lambe Rebecca-Jane Law Yulan Lin Martin Malmberg Donna Turner Richard D Neal Victoria White Samantha Harrison Peter Vedsted Una MacLeod Conan Donnelly Anna Gavin Jon Emery Oliver Bucher Jatinderpal Kalsi Chantelle Anandan Evangelia Ourania Fourkala Therese Kearney Marie-Louise Essink-Bot Sigrun Saur Almberg Breann Hawryluk Jacqueline Kelly Jackie Boylan Jan Willem Coebergh David Brewster Stefan Bergström Victoria Hammersley Rebecca Bergin Alina Zalounina Falborg Andriana Barisi Kerry Moore Maria Rejmyr Davis Diagnostic pathways for breast cancer in 10 International Cancer Benchmarking Partnership (ICBP) jurisdictions: an international comparative cohort study based on questionnaire and registry data BMJ Open |
| title | Diagnostic pathways for breast cancer in 10 International Cancer Benchmarking Partnership (ICBP) jurisdictions: an international comparative cohort study based on questionnaire and registry data |
| title_full | Diagnostic pathways for breast cancer in 10 International Cancer Benchmarking Partnership (ICBP) jurisdictions: an international comparative cohort study based on questionnaire and registry data |
| title_fullStr | Diagnostic pathways for breast cancer in 10 International Cancer Benchmarking Partnership (ICBP) jurisdictions: an international comparative cohort study based on questionnaire and registry data |
| title_full_unstemmed | Diagnostic pathways for breast cancer in 10 International Cancer Benchmarking Partnership (ICBP) jurisdictions: an international comparative cohort study based on questionnaire and registry data |
| title_short | Diagnostic pathways for breast cancer in 10 International Cancer Benchmarking Partnership (ICBP) jurisdictions: an international comparative cohort study based on questionnaire and registry data |
| title_sort | diagnostic pathways for breast cancer in 10 international cancer benchmarking partnership icbp jurisdictions an international comparative cohort study based on questionnaire and registry data |
| url | https://bmjopen.bmj.com/content/12/12/e059669.full |
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