title: Factors affecting breast cancer treatment delay in Turkey: a study from Turkish Federation of Breast Diseases Societies.
abstract: BACKGROUND
  One of the most important factors in breast cancer (BC) mortality is treatment delay. The primary goal of this survey was to identify factors affecting the total delay time (TDT) in Turkish BC patients.
  
  
  METHODS
  A total of 1031 patients with BC were surveyed using a uniform questionnaire. The time between discovering the first symptom and signing up for the first medical visit (patient delay time; PDT) and the time between the first medical visit and the start of therapy (system delay time; SDT) were modelled separately with multilevel regression.
  
  
  RESULTS
  The mean PDT, SDT and TDT were 4.8, 10.5 and 13.8 weeks, respectively. In all, 42% of the patients had a TDT >12 weeks. Longer PDT was significantly correlated with disregarding symptoms and having age of between 30 and 39 years. Shorter PDT was characteristic of patients who: had stronger self-examination habits, received more support from family and friends and had at least secondary education. Predictors of longer SDT included disregard of symptoms, distrust in success of therapy and medical system and having PDT in excess of 4 weeks. Shorter SDT was linked to the age of >60 years. Patients who were diagnosed during a periodic check-up or opportunistic mammography displayed shorter SDT compared with those who had symptomatic BC and their first medical examination was by a surgeon.
  
  
  CONCLUSIONS
  TDT in Turkey is long and remains a major problem. Delays can be reduced by increasing BC awareness, implementing organized population-based screening programmes and founding cancer centres.
authors.affiliation: 1 Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey vozmen@istanbul.edu.tr.
authors.forename: Vahit
authors.initials: V
authors.lastname: Ozmen
authors.affiliation: 2 Department of General Surgery, Medical Faculty, Adnan Menderes University, Aydin, Turkey.
authors.forename: Sukru
authors.initials: S
authors.lastname: Boylu
authors.affiliation: 3 Department of General Surgery, Medical Faculty, Erciyes University, Kayseri, Turkey.
authors.forename: Engin
authors.initials: E
authors.lastname: Ok
authors.affiliation: 4 Department of General Surgery, Medical Faculty, Kocaeli University, Kocaeli, Turkey.
authors.forename: Nuh Zafer
authors.initials: NZ
authors.lastname: Canturk
authors.affiliation: 5 Department of General Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Varol
authors.initials: V
authors.lastname: Celik
authors.affiliation: 6 Department of General Surgery, Medical Faculty, Ege University, Izmir, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Kapkac
authors.affiliation: 7 Department of General Surgery, Medical Faculty, Dicle University, Diyarbakir, Turkey.
authors.forename: Sadullah
authors.initials: S
authors.lastname: Girgin
authors.affiliation: 8 Department of General Surgery, Medical Faculty, Celal Bayar University, Manisa, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Tireli
authors.affiliation: 9 Department of General Surgery, Medical Faculty, Osmangazi University, Eskisehir, Turkey.
authors.forename: Enver
authors.initials: E
authors.lastname: Ihtiyar
authors.affiliation: 10 Department of General Surgery, Medical Faculty, Acibadem University, Adana, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Demircan
authors.affiliation: 11 Department of General Surgery, Medical Faculty, Ankara University, Ankara, Turkey.
authors.forename: Mazhar Semih
authors.initials: MS
authors.lastname: Baskan
authors.affiliation: 12 Department of General Surgery, Medical Faculty, Cumhuriyet University, Sivas, Turkey.
authors.forename: Ayhan
authors.initials: A
authors.lastname: Koyuncu
authors.affiliation: 13 Department of Medical Oncology, Medical Faculty, Uludag University, Bursa, Turkey.
authors.forename: Ismet
authors.initials: I
authors.lastname: Tasdelen
authors.affiliation: 14 Medical Department, Roche Mustahzarlari San. A.S., Istanbul, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Dumanli
authors.affiliation: 14 Medical Department, Roche Mustahzarlari San. A.S., Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Ozdener
authors.affiliation: 15 Collegium of World Economy, Warsaw School of Economics, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Zaborek
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D055088:Early Detection of Cancer / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D013997:Time Factors; D014421:Turkey; D014850:Waiting Lists
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