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Breast cancer patient delay in Fukushima, Japan following the 2011 triple disaster: a long-term retrospective study
BACKGROUND: Little information is available concerning how patient delay may be affected by mass disasters. The main objectives of the present study are to identify whether there was a post-disaster increase in the risk of experiencing patient delay among breast cancer patients in an area affected b...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477136/ https://www.ncbi.nlm.nih.gov/pubmed/28629330 http://dx.doi.org/10.1186/s12885-017-3412-4 |
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author | Ozaki, Akihiko Nomura, Shuhei Leppold, Claire Tsubokura, Masaharu Tanimoto, Tetsuya Yokota, Takeru Saji, Shigehira Sawano, Toyoaki Tsukada, Manabu Morita, Tomohiro Ochi, Sae Kato, Shigeaki Kami, Masahiro Nemoto, Tsuyoshi Kanazawa, Yukio Ohira, Hiromichi |
author_facet | Ozaki, Akihiko Nomura, Shuhei Leppold, Claire Tsubokura, Masaharu Tanimoto, Tetsuya Yokota, Takeru Saji, Shigehira Sawano, Toyoaki Tsukada, Manabu Morita, Tomohiro Ochi, Sae Kato, Shigeaki Kami, Masahiro Nemoto, Tsuyoshi Kanazawa, Yukio Ohira, Hiromichi |
author_sort | Ozaki, Akihiko |
collection | PubMed |
description | BACKGROUND: Little information is available concerning how patient delay may be affected by mass disasters. The main objectives of the present study are to identify whether there was a post-disaster increase in the risk of experiencing patient delay among breast cancer patients in an area affected by the 2011 triple disaster in Fukushima, Japan, and to elucidate factors associated with post-disaster patient delay. Sociodemographic factors (age, employment status, cohabitant status and evacuation status), health characteristics, and health access- and disaster-related factors were specifically considered. METHODS: Records of symptomatic breast cancer patients diagnosed from 2005 to 2016 were retrospectively reviewed to calculate risk ratios (RRs) for patient delay in every year post-disaster compared with the pre-disaster baseline. Total and excessive patient delays were respectively defined as three months or more and twelve months or more from symptom recognition to first medical consultation. Logistic regression analysis was conducted for pre- and post-disaster patient delay in order to reveal any factors potentially associated with patient delay, and changes after the disaster. RESULTS: Two hundred nineteen breast cancer patients (122 pre-disaster and 97 post-disaster) were included. After adjustments for age, significant post-disaster increases in RRs of experiencing both total (RR: 1.66, 95% Confidence Interval (CI): 1.02–2.70, p < 0.05) and excessive patient delay (RR: 4.49, 95% CI: 1.73–11.65, p < 0.01) were observed. The RRs for total patient delay peaked in the fourth year post-disaster, and significant increases in the risk of excessive patient delay were observed in the second, fourth, and fifth years post-disaster, with more than five times the risk observed pre-disaster. A family history of any cancer was the only factor significantly associated with total patient delay post-disaster (odds ratio: 0.38, 95% CI: 0.15–0.95, p < 0.05), while there were no variables associated with delay pre-disaster. CONCLUSIONS: The triple disaster in Fukushima appears to have led to an increased risk of patient delay among breast cancer patients, and this trend has continued for five years following the disaster. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12885-017-3412-4) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5477136 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-54771362017-06-22 Breast cancer patient delay in Fukushima, Japan following the 2011 triple disaster: a long-term retrospective study Ozaki, Akihiko Nomura, Shuhei Leppold, Claire Tsubokura, Masaharu Tanimoto, Tetsuya Yokota, Takeru Saji, Shigehira Sawano, Toyoaki Tsukada, Manabu Morita, Tomohiro Ochi, Sae Kato, Shigeaki Kami, Masahiro Nemoto, Tsuyoshi Kanazawa, Yukio Ohira, Hiromichi BMC Cancer Research Article BACKGROUND: Little information is available concerning how patient delay may be affected by mass disasters. The main objectives of the present study are to identify whether there was a post-disaster increase in the risk of experiencing patient delay among breast cancer patients in an area affected by the 2011 triple disaster in Fukushima, Japan, and to elucidate factors associated with post-disaster patient delay. Sociodemographic factors (age, employment status, cohabitant status and evacuation status), health characteristics, and health access- and disaster-related factors were specifically considered. METHODS: Records of symptomatic breast cancer patients diagnosed from 2005 to 2016 were retrospectively reviewed to calculate risk ratios (RRs) for patient delay in every year post-disaster compared with the pre-disaster baseline. Total and excessive patient delays were respectively defined as three months or more and twelve months or more from symptom recognition to first medical consultation. Logistic regression analysis was conducted for pre- and post-disaster patient delay in order to reveal any factors potentially associated with patient delay, and changes after the disaster. RESULTS: Two hundred nineteen breast cancer patients (122 pre-disaster and 97 post-disaster) were included. After adjustments for age, significant post-disaster increases in RRs of experiencing both total (RR: 1.66, 95% Confidence Interval (CI): 1.02–2.70, p < 0.05) and excessive patient delay (RR: 4.49, 95% CI: 1.73–11.65, p < 0.01) were observed. The RRs for total patient delay peaked in the fourth year post-disaster, and significant increases in the risk of excessive patient delay were observed in the second, fourth, and fifth years post-disaster, with more than five times the risk observed pre-disaster. A family history of any cancer was the only factor significantly associated with total patient delay post-disaster (odds ratio: 0.38, 95% CI: 0.15–0.95, p < 0.05), while there were no variables associated with delay pre-disaster. CONCLUSIONS: The triple disaster in Fukushima appears to have led to an increased risk of patient delay among breast cancer patients, and this trend has continued for five years following the disaster. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12885-017-3412-4) contains supplementary material, which is available to authorized users. BioMed Central 2017-06-19 /pmc/articles/PMC5477136/ /pubmed/28629330 http://dx.doi.org/10.1186/s12885-017-3412-4 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Ozaki, Akihiko Nomura, Shuhei Leppold, Claire Tsubokura, Masaharu Tanimoto, Tetsuya Yokota, Takeru Saji, Shigehira Sawano, Toyoaki Tsukada, Manabu Morita, Tomohiro Ochi, Sae Kato, Shigeaki Kami, Masahiro Nemoto, Tsuyoshi Kanazawa, Yukio Ohira, Hiromichi Breast cancer patient delay in Fukushima, Japan following the 2011 triple disaster: a long-term retrospective study |
title | Breast cancer patient delay in Fukushima, Japan following the 2011 triple disaster: a long-term retrospective study |
title_full | Breast cancer patient delay in Fukushima, Japan following the 2011 triple disaster: a long-term retrospective study |
title_fullStr | Breast cancer patient delay in Fukushima, Japan following the 2011 triple disaster: a long-term retrospective study |
title_full_unstemmed | Breast cancer patient delay in Fukushima, Japan following the 2011 triple disaster: a long-term retrospective study |
title_short | Breast cancer patient delay in Fukushima, Japan following the 2011 triple disaster: a long-term retrospective study |
title_sort | breast cancer patient delay in fukushima, japan following the 2011 triple disaster: a long-term retrospective study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477136/ https://www.ncbi.nlm.nih.gov/pubmed/28629330 http://dx.doi.org/10.1186/s12885-017-3412-4 |
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