Breast cancer detection method, diagnostic interval and use of specialized diagnostic assessment units across Ontario, Canada
Introduction: Breast cancer is detected through screening or through signs and symptoms. In Canada, mammograms for breast cancer screening are offered in organized programs or independently (opportunistic screening). Province of Ontario breast Diagnostic Assessment Units (DAUs) are facility-based pr...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Health Agency of Canada
2018-10-01
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| Series: | Health Promotion and Chronic Disease Prevention in Canada |
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| Online Access: | https://doi.org/10.24095/hpcdp.38.10.02 |
| _version_ | 1818128480862208000 |
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| author | Li Jiang Julie Gilbert Hugh Langley Rahim Moineddin Patti A. Groome |
| author_facet | Li Jiang Julie Gilbert Hugh Langley Rahim Moineddin Patti A. Groome |
| author_sort | Li Jiang |
| collection | DOAJ |
| description | Introduction: Breast cancer is detected through screening or through signs and symptoms. In Canada, mammograms for breast cancer screening are offered in organized programs or independently (opportunistic screening). Province of Ontario breast Diagnostic Assessment Units (DAUs) are facility-based programs that provide coordinated breast cancer diagnostic services, as opposed to usual care, in which the primary care provider arranges the tests and consultations. This study describes breast cancer detection method, diagnostic interval and DAU use across Ontario. Methods: The study cohort consisted of 6898 women with invasive breast cancer diagnosed in 2011. We used the Ontario Cancer Registry linked to administrative health care databases. We determined the detection method using the Ontario Breast Screening Program (OBSP) data and physician claims. The diagnostic interval was the time between the initial screen, specialist referral or first diagnostic test and the cancer diagnosis. The diagnostic route (whether through DAU or usual care) was determined based on the OBSP records and biopsy or surgery location. We mapped the diagnostic interval and DAU coverage geographically by women’s residence. Results: In 2011, 36% of Ontario breast cancer patients were screen-detected, with a 48% rate among those aged 50 to 69. The provincial median diagnostic interval was 32 days, with county medians ranging from 15 to 65 days. Provincially, 48.4% were diagnosed at a DAU, and this ranged from zero to 100% across counties. Conclusion: The screening detection rate in age-eligible breast cancer patients was lower than published population-wide screening rates. Geographic mapping of the diagnostic interval and DAU use reveals regional variations in cancer diagnostic care that need to be addressed. |
| first_indexed | 2024-12-11T07:33:56Z |
| format | Article |
| id | doaj.art-f9ab92918e24419b9915acd082c20045 |
| institution | Directory Open Access Journal |
| issn | 2368-738X |
| language | English |
| last_indexed | 2024-12-11T07:33:56Z |
| publishDate | 2018-10-01 |
| publisher | Public Health Agency of Canada |
| record_format | Article |
| series | Health Promotion and Chronic Disease Prevention in Canada |
| spelling | doaj.art-f9ab92918e24419b9915acd082c200452022-12-22T01:15:45ZengPublic Health Agency of CanadaHealth Promotion and Chronic Disease Prevention in Canada2368-738X2018-10-01381035836710.24095/hpcdp.38.10.02stringBreast cancer detection method, diagnostic interval and use of specialized diagnostic assessment units across Ontario, CanadaLi Jiang0Julie Gilbert1Hugh Langley2Rahim Moineddin3Patti A. Groome4Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, CanadaCancer Care Ontario, Toronto, Ontario, CanadaSouth East Regional Cancer Program, Kingston General Hospital, Kingston, Ontario, CanadaDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, CanadaDivision of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, CanadaIntroduction: Breast cancer is detected through screening or through signs and symptoms. In Canada, mammograms for breast cancer screening are offered in organized programs or independently (opportunistic screening). Province of Ontario breast Diagnostic Assessment Units (DAUs) are facility-based programs that provide coordinated breast cancer diagnostic services, as opposed to usual care, in which the primary care provider arranges the tests and consultations. This study describes breast cancer detection method, diagnostic interval and DAU use across Ontario. Methods: The study cohort consisted of 6898 women with invasive breast cancer diagnosed in 2011. We used the Ontario Cancer Registry linked to administrative health care databases. We determined the detection method using the Ontario Breast Screening Program (OBSP) data and physician claims. The diagnostic interval was the time between the initial screen, specialist referral or first diagnostic test and the cancer diagnosis. The diagnostic route (whether through DAU or usual care) was determined based on the OBSP records and biopsy or surgery location. We mapped the diagnostic interval and DAU coverage geographically by women’s residence. Results: In 2011, 36% of Ontario breast cancer patients were screen-detected, with a 48% rate among those aged 50 to 69. The provincial median diagnostic interval was 32 days, with county medians ranging from 15 to 65 days. Provincially, 48.4% were diagnosed at a DAU, and this ranged from zero to 100% across counties. Conclusion: The screening detection rate in age-eligible breast cancer patients was lower than published population-wide screening rates. Geographic mapping of the diagnostic interval and DAU use reveals regional variations in cancer diagnostic care that need to be addressed.https://doi.org/10.24095/hpcdp.38.10.02breast neoplasms/diagnosis, female, diagnostic services, early detection of cancer, early diagnosis, cross-sectional studies, health services research |
| spellingShingle | Li Jiang Julie Gilbert Hugh Langley Rahim Moineddin Patti A. Groome Breast cancer detection method, diagnostic interval and use of specialized diagnostic assessment units across Ontario, Canada Health Promotion and Chronic Disease Prevention in Canada breast neoplasms/diagnosis, female, diagnostic services, early detection of cancer, early diagnosis, cross-sectional studies, health services research |
| title | Breast cancer detection method, diagnostic interval and use of specialized diagnostic assessment units across Ontario, Canada |
| title_full | Breast cancer detection method, diagnostic interval and use of specialized diagnostic assessment units across Ontario, Canada |
| title_fullStr | Breast cancer detection method, diagnostic interval and use of specialized diagnostic assessment units across Ontario, Canada |
| title_full_unstemmed | Breast cancer detection method, diagnostic interval and use of specialized diagnostic assessment units across Ontario, Canada |
| title_short | Breast cancer detection method, diagnostic interval and use of specialized diagnostic assessment units across Ontario, Canada |
| title_sort | breast cancer detection method diagnostic interval and use of specialized diagnostic assessment units across ontario canada |
| topic | breast neoplasms/diagnosis, female, diagnostic services, early detection of cancer, early diagnosis, cross-sectional studies, health services research |
| url | https://doi.org/10.24095/hpcdp.38.10.02 |
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