title: Sex bias in diagnostic delay in bronchiectasis: An analysis of the Spanish Historical Registry of Bronchiectasis.
abstract: Diagnostic delay is common in most respiratory diseases, particularly in bronchiectasis. However, sex bias in diagnostic delay has not been studied to date.
  
  
  OBJECTIVE
  Assessment of diagnostic delay in bronchiectasis by sex.
  
  
  METHODS
  The Spanish Historical Registry of Bronchiectasis recruited adults diagnosed with bronchiectasis from 2002 to 2011 in 36 centres in Spain. From a total of 2113 patients registered we studied 2099, of whom 1125 (53.6%) were women.
  
  
  RESULTS
  No differences were found for sex or age (61.0 ± 20.6, p = 0.88) or for localization of bronchiectasis ( p = 0.31). Bronchiectasis of unknown aetiology and secondary to asthma, childhood infections and tuberculosis was more common in women (all ps < 0.05). More men than women were chronic obstructive pulmonary disease-related bronchiectasis and colonized by Haemophilus influenzae ( p < 0.001 for both). Onset of symptoms was earlier in women. The diagnostic delay for women with bronchiectasis was 2.1 years more than for men ( p = 0.001).
  
  
  CONCLUSIONS
  We recorded a substantial delay in the diagnosis of bronchiectasis. This delay was significantly longer in women than in men (>2 years). Independent factors associated with this sex bias were age at onset of symptoms, smoking history, daily expectoration and reduced lung function.
authors.affiliation: 1 Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, Madrid, Spain.
authors.forename: Rosa Ma
authors.initials: RM
authors.lastname: Girón
authors.affiliation: 2 Hospital Universitari Vall d'Hebron, Universitat Autònoma Barcelona, Ciberes Enfermedades Respiratorias CB06/060030, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: de Gracia Roldán
authors.affiliation: 3 Hospital Regional Universitario de Málaga, Instituto de Biomedicina de Málaga (IBIMA), Málaga, Spain.
authors.forename: Casilda
authors.initials: C
authors.lastname: Olveira
authors.affiliation: 4 Dr Trueta University Hospital, Bronchiectasis Group IDIBGI, Universitat de Girona, Ciberes, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Vendrell
authors.affiliation: 5 Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Martínez-García
authors.affiliation: 6 Hospital Plató, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: de la Rosa
authors.affiliation: 7 Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Máiz
authors.affiliation: 1 Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, Madrid, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Ancochea
authors.affiliation: 1 Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, Madrid, Spain.
authors.forename: Liliana
authors.initials: L
authors.lastname: Vázquez
authors.affiliation: 8 Hospital General San Jorge, Huesca, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Borderías
authors.affiliation: 9 Hospital Clínic i Provincial, Barcelona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Polverino
authors.affiliation: 10 Hospital Universitario Dr. Peset, Valencia, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Martínez-Moragón
authors.affiliation: 1 Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, Madrid, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Rajas
authors.affiliation: 1 Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, Madrid, Spain.
authors.forename: Joan B
authors.initials: JB
authors.lastname: Soriano
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000150:complications; D015982:Bias; D001980:Bronchi / Q000382:microbiology; D001987:Bronchiectasis / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D057210:Delayed Diagnosis / Q000706:statistics & numerical data*; D005260:Female; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012042:Registries; D012737:Sex Factors; D012907:Smoking; D013030:Spain; D013183:Sputum; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000150:complications
keywords: Bronchiectasis; diagnostic delay; gender bias; gender gap; sex bias