Background
Methods
Study design
Data collection
Outcome measures
Analyses
Ethics approval
Results
Cancer type | N |
---|---|
All Cancers | 1892 |
Breast cancer | 291 |
Colorectal cancer | 254 |
Lung cancer | 253 |
Prostate cancer | 190 |
Melanoma | 122 |
Bladder cancer | 73 |
Non-Hodgkin's lymphoma | 54 |
Pancreas cancer | 54 |
Ovarian cancer | 47 |
Corpus uteri cancer | 41 |
Other | 513 |
Gender and delay
Patient delay; OR(95%CI) | Doctor delay; OR(95%CI) | System delay; OR(95%CI) | |||||
---|---|---|---|---|---|---|---|
N | Univariate | N | Univariate | N | Univariate | ||
All | Female | 634(135) | 1 | 994(70) | 1 | 813(172) | 1 |
Male | 603(155) | 1.28(0.95 to 1.71) | 883(98) |
1.65(1.19 to 2.28)
| 609(203) |
1.86(1.48 to 2.35)
| |
Without gender | Female | 373(81) | 1 | 575(53) | 1 | 428(119) | 1 |
specific cancer | Male | 471(107) | 1.06(0.74 to 1.52) | 670(77) | 1.28(0.87 to 1.88) | 469(136) | 1.06(0.81 to 1.39) |
Socioeconomic patient characteristics and delay
Predictors | Patient delay; OR(95%CI) | Doctor delay; OR(95%CI) | System delay; OR(95%CI) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N | Univariate | N | Multivariate | N | Univariate | N | Multivariate | N | Univariate | N | Multivariate | ||
Age | 18–49 | 102(23) | 0.91(0.51 to 1.63) | 62(17) | 0.63(0.29 to 1.39 | 177(13) | 1.31(0.65 to 2.64 | 113(9) | 0.92(0.35 to 2.39 | 162(35) | 1.05(0.66 to 1.67 | 105(20) | 0.78(0.39 to 1.53 |
50–69 | 265(64) | 1 | 136(41) | 1 | 403(23) | 1 | 212(14) | 1 | 351(73) | 1 | 198(35) | 1 | |
70+ | 267(48) | 0.69(0.44 to 1.08) | 70(8) | 0.72(0.25 to 2.09) | 414(34) | 1.48(0.87 to 2.50) | 104(8) | 1.85(0.42 to 8.21) | 300(64) | 1.03(0.70 to 1.53) | 88(16) | 1.26(0.50 to 3.15) | |
Marital status | Cohabiting | 197(53) | 1 | 176(49) | 1 | 322(20) | 1 | 288(19) | 1 | 301(48) | 1 | 269(42) | 1 |
Single | 114(24) | 0.72(0.43 to 1.23) | 92(17) | 0.82(0.38 to 1.75) | 180(15) | 1.37(0.69 to 2.71) | 141(12) | 1.07(0.46 to 2.50) | 156(35) | 1.52(0.93 to 2.51) | 122(29) | 1.44(0.79 to 2.63) | |
Having Children | Yes | 273(65) | 1 | 235(55) | 1 | 442(30) | 1 | 375(27) | 1 | 401(70) | 1 | 341(59) | 1 |
No | 36(11) | 1.41(0.68 to 2.94) | 33(11) | 1.77(0.80 to 3.92) | 59(5) | 1.27(0.48 to 3.40) | 54(4) | 0.77(0.25 to 2.36) | 55(13) | 1.46(0.70 to 3.06) | 50(12) | 1.20(0.55 to 2.60) | |
Education | < 3 years | 147(35) | 1 | 134(33) | 1 | 235(16) | 1 | 209(15) | 1 | 224(35) | 1 | 199(28) | 1 |
≥ 3 years | 83(22) | 1.15(0.62 to 2.15 | 79(2) | 1.12(0.55 to 2.27 | 143(5) | 0.50(0.18 to 1.40 | 133(5) | 0.45(0.15 to 1.35 | 128(26) | 1.38(0.78 to 2.43) | 118(26) | 1.76(0.94 to 3.28 | |
No | 72(18) | 1.07(0.54 to 2.09) | 55(12) | 1.42(0.60 to 3.36) | 110(13) | 1.83(0.85 to 3.94) | 87(11) | 1.83(0.79 to 4.24) | 96(21) | 1.51(0.82 to 2.79) | 74(17) | 1.50(0.74 to 3.03) | |
Occupation | Working1
| 137(44) | 1 | 129(42) | 1 | 223(14) | 1 | 210(14) | 1 | 212(44) | 1 | 199(40) | 1 |
Not working2
| 42(11) | 0.75(0.34 to 1.67 | 32(10) | 0.81(0.34 to 1.95 | 71(9) | 2.17(0.89 to 5.29 | 54(8) | 1.93(0.68 to 5.44 | 62(12) | 0.92(0.47 to 1.79 | 46(8) | 0.69(0.32 to 1.49 | |
Retirees3
| 130(23) |
0.45(0.26 to 0.81)
| 107(14) |
0.35(0.13 to 0.98)
| 206(12) | 0.92(0.43 to 1.99) | 165(9) | 0.35(0.06 to 1.93) | 181(27) | 0.67(0.39 to 1.15) | 146(23) | 0.42(0.16 to 1.09) | |
Household income | Low/middle | 221(51) | 1 | 201(44) | 1 | 362(25) | 1 | 327(24) | 1 | 324(62) | 1 | 294(59) | 1 |
High | 68(22) | 1.59(0.88 to 2.89) | 67(22) | 1.30(0.60 to 2.82) | 104(7) | 0.97(0.41 to 2.28) | 102(7) | 1.50(0.50 to 4.53) | 99(13) | 0.64(0.34 to 1.21) | 97(12) | 0.55(0.26 to 1.19) | |
Household fortune | Small/medium | 196(46) | 1 | 185(42) | 1 | 331(31) | 1 | 313(30) | 1 | 302(62) | 1 | 287(60) | 1 |
Large | 86(24) | 1.26(0.73 to 2.18) | 83(24) | 1.36(0.72 to 2.56) | 120(1) |
0.08(0.01 to 0.61)
| 116(1) |
0.07(0.01 to 0.45)
| 108(13) | 0.53(0.27 to 1.02) | 104(11) |
0.46(0.21 to 0.99)
| |
Smoking | No | 240(53) | 1 | 209(45) | 1 | 378(27) | 1 | 329(24) | 1 | 343(61) | 1 | 298(53) | 1 |
Yes | 70(25) |
1.96(1.09 to 3.51)
| 59(21) |
2.42(1.21 to 4.85)
| 120(8) | 0.93(0.41 to 2.12) | 100(7) | 0.57(0.23 to 1.41) | 111(22) | 1.14(0.65 to 2.00) | 93(18) | 1.01(0.56 to 1.84) | |
Alcohol intake per week4
| ≤ 14 | 287(73) | 1 | 251(63) | 1 | 464(31) | 1 | 405(28) | 1 | 424(75) | 1 | 369(64) | 1 |
>14 | 17(3) | 0.63(0.18 to 2.23) | 17(3) | 0.51(0.14 to 1.92) | 26(3) | 1.82(0.51 to 6.55) | 24(3) | 2.88(0.67 to 12.4) | 23(7) | 2.04(0.82 to 5.08) | 22(7) |
2.82(1.18 to 6.72)
|
Predictors | Patient delay; OR(95%CI) | Doctor delay; OR(95%CI) | System delay; OR(95%CI) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N | Univariate | N | Multivariate | N | Univariate | N | Multivariate | N | Univariate | N | Multivariate | ||
Age | 18–49 | 52(9) |
0.43(0.20 to 0.92)
| 25(5) | 0.63(0.19 to 2.11) | 78(8) | 1.10(0.50 to 2.44) | 39(3) | 0.80(0.19 to 3.42) | 68(13) |
0.53(0.28 to 0.99)
| 37(8) | 0.68(0.27 to 1.72) |
50–69 | 259(85) | 1 | 109(37) | 1 | 384(36) | 1 | 167(21) | 1 | 278(86) | 1 | 134(43) | 1 | |
70+ | 292(61) |
0.54(0.37 to 0.79)
| 97(20) | 0.45(0.20 to 1.00) | 421(54) | 1.42(0.96 to 2.10) | 132(43) | 1.07(0.47 to 2.45) | 263(104) |
1.46(1.04 to 2.06)
| 103(39) | 1.25(0.57 to 2.76) | |
Marital status | Cohabiting | 212(56) | 1 | 185(49) | 1 | 308(40) | 1 | 270(37) | 1 | 249(86) | 1 | 220(72) | 1 |
Single | 61(16) | 0.99(0.50 to 1.95) | 46(13) | 1.18(0.46 to 3.06) | 85(8) | 0.70(0.32 to 1.51) | 68(6) | 0.45(0.17 to 1.18) | 67(22) | 0.93(0.50 to 1.71) | 54(18) | 0.96(0.44 to 2.10) | |
Having children | Yes | 244(63) | 1 | 208(54) | 1 | 354(41) | 1 | 308(39) | 1 | 284(99) | 1 | 250(84) | 1 |
No | 24(8) | 1.44(0.58 to 3.55) | 23(8) | 1.58(0.50 to 5.02) | 32(5) | 1.41(0.53 to 3.77) | 30(4) | 1.50(0.43 to 5.21) | 26(7) | 0.69(0.28 to 1.71) | 24(6) | 0.64(0.19 to 2.14) | |
Education | < 3 years | 171(45) | 1 | 143(37) | 1 | 242(35) | 1 | 208(32) | 1 | 194(67) | 1 | 168(55) | 1 |
≥ 3 years | 77(23) | 1.19(0.66 to 2.15 | 74(22) | 1.02(0.49 to 2.13 | 110(6) |
0.34(0.14 to 0.81
| 106(6) |
0.40(0.16 to 1.00
| 90(29) | 0.90(0.51 to 1.58) | 86(27) | 1.02(0.54 to 1.93 | |
No | 17(3) | 0.60(0.17 to 2.10) | 14(3) | 0.81(0.21 to 3.14) | 31(6) | 1.42(0.56 to 3.57) | 24(5) | 1.31(0.48 to 3.57) | 25(9) | 1.07(0.44 to 2.56) | 20(8) | 1.30(0.47 to 3.56) | |
Occupation | Working1
| 89(23) | 1 | 82(21) | 1 | 133(13) | 1 | 125(11) | 1 | 114(30) | 1 | 108(27) | 1 |
Not working2
| 25(9) | 1.61(0.66 to 3.92 | 21(9) | 2.36(0.86 to 6.52 | 37(6) | 1.79(0.62 to 5.17 | 31(6) | 1.88(0.61 to 5.83 | 31(12) | 1.77(0.73 to 4.28 | 27(12) | 2.32(0.85 to 6.32 | |
Retirees3
| 158(39) | 0.94(0.52 to 1.71) | 128(32) | 1.67(0.68 to 4.10) | 222(29) | 1.39(0.71 to 2.69) | 182(26) | 1.27(0.48 to 3.39) | 170(64) |
1.69(1.02 to 2.79)
| 139(51) | 1.31(0.54 to 3.20) | |
Household income | Low/middle | 207(52) | 1 | 179(44) | 1 | 293(42) | 1 | 258(38) | 1 | 233(82) | 1 | 206(72) | 1 |
High | 54(18) | 1.49(0.75 to 2.95) | 52(18) | 1.23(0.46 to 3.30) | 82(5) | 0.39(0.15 to 1.04) | 80(5) | 0.59(0.20 to 1.75) | 69(19) | 0.70(0.38 to 1.29) | 68(18) | 1.02(0.44 to 2.37) | |
Household fortune | Small/medium | 131(29) | 1 | 116(25) | 1 | 199(26) | 1 | 183(26) | 1 | 163(60) | 1 | 151(53) | 1 |
Large | 120(37) | 1.57(0.88 to 2.80) | 115(37) | 1.83(0.89 to 3.78) | 161(18) | 0.84(0.44 to 1.60) | 155(17) | 0.86(0.41 to 1.80) | 128(38) | 0.72(0.44 to 1.20) | 123(37) | 0.77(0.42 to 1.41) | |
Smoking | No | 204(52) | 1 | 168(45) | 1 | 296(36) | 1 | 250(32) | 1 | 241(80) | 1 | 205(65) | 1 |
Yes | 70(20) | 1.17(0.64 to 2.15) | 63(17) | 1.03(0.50 to 2.13) | 98(12) | 1.01(0.50 to 2.02) | 88(11) | 0.86(0.42 to 1.79) | 76(28) | 1.17(0.71 to 1.95) | 69(25) | 1.11(0.61 to 2.01) | |
Alcohol intake per week4
| ≤21 | 237(58) | 1 | 251(63) | 1 | 345(42) | 1 | 296(38) | 1 | 275(92) | 1 | 239(77) | 1 |
>21 | 31(13) |
2.23(1.05 to 4.73)
| 17(3) | 1.86(0.81 to 4.28) | 43(5) | 0.95(0.35 to 2.60) | 42(5) | 1.25(0.42 to 3.73) | 36(13) | 1.12(0.54 to 2.36) | 35(13) | 1.24(0.54 to 2.83) |
Patient delay
Doctor delay
System delay
Exclusion of gender-specific cancers
Predictors | Patient delay; OR(95%CI) | Doctor delay; OR(95%CI) | System delay; OR(95%CI) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N | Univariate | N | Multivariate | N | Univariate | N | Multivariate | N | Univariate | N | Multivariate | ||
Gender | Female | 373(81) | 1 | 124(35) | 1 | 575(53) | 1 | 199(18) | 1 | 428(119) | 1 | 173(44) | 1 |
Male | 471(107) | 1.06(0.74 to 1.52) | 164(42) | 0.77(0.42 to 1.44) | 670(77) | 1.28(0.87 to 1.88) | 233(34) |
2.11(1.11 to 4.02)
| 469(136) | 1.06(0.81 to 1.39) | 200(54) | 1.18(0.73 to 1.93) | |
Age | 18–49 | 71(19) | 0.94(0.52 to 1.71) | 36(11) | 1.00(0.41 to 2.46) | 131(14) | 1.19(0.65 to 2.17) | 72(7) | 0.95(0.37 to 2.42) | 116(31) | 1.00(0.64 to | 66(16) | 1.13(0.55 to 2.30) |
50–69 | 369(103) | 1 | 152(53) | 1 | 526(48) | 1 | 221(27) | 1 | 407(109) | 1 | 192(48) | 1 | |
70+ | 404(66) | 0.50(0.36 to 0.71) | 100(13) |
0.30(0.13 to 0.71)
| 588(68) | 1.30(0.91 to 1.86) | 139(18) | 1.34(0.51 to 3.54) | 374(115) | 1.21(0.89 to 1.66) | 115(34) | 1.15(0.50 to 2.63) | |
Marital status | Cohabiting | 229(62) | 1 | 204(58) | 1 | 348(42) | 1 | 310(39) | 1 | 304(75) | 1 | 273(66) | 1 |
Single | 103(23) | 0.77(0.45 to 1.35) | 84(19) | 0.98(0.51 to 1.90) | 152(17) | 0.92(0.51 to 1.64) | 122(13) | 0.67(0.33 to 1.36) | 124(38) | 1.35(0.85 to 2.14) | 100(32) | 1.07(0.60 to 1.89) | |
Having children | Yes | 301(74) | 1 | 262(67) | 1 | 450(50) | 1 | 390(46) | 1 | 381(99) | 1 | 334(86) | 1 |
No | 28(10) | 1.70(0.75 to 3.86) | 26(10) | 1.63(0.67 to 3.96) | 46(8) | 1.68(0.75 to 3.78) | 42(6) | 1.37(0.52 to 3.59) | 43(13) | 1.23(0.61 to 2.48) | 39(12) | 1.14(0.52 to 2.54) | |
Education | < 3 years | 178(47) | 1 | 159(43) | 1 | 263(37) | 1 | 234(35) | 1 | 230(59) | 1 | 206(51) | 1 |
≥ 3 years | 94(26) | 1.07(0.59 to 1.93) | 90(25) | 0.92(0.46 to 1.82) | 140(5) |
0.23(0.09 to 0.56)
| 133(5) |
0.23(0.09 to 0.63)
| 120(31) | 1.01(0.60 to 1.70) | 113(30) | 1.45(0.82 to 2.57) | |
No | 47(11) | 0.85(0.40 to 1.83) | 39(9) | 1.39(0.53 to 3.66) | 79(15) | 1.43(0.74 to 2.77) | 65(12) | 1.59(0.74 to 3.41) | 66(20) | 1.26(0.69 to 2.29) | 54(17) | 1.20(0.60 to 2.41) | |
Occupation | Working1
| 122(37) | 1 | 114(35) | 1 | 191(18) | 1 | 177(18) | 1 | 175(39) | 1 | 161(35) | 1 |
Not working2
| 43(17) | 1.50(0.71 to 3.18) | 36(17) | 2.22(0.96 to 5.13) | 70(11) | 1.79(0.79 to 4.04) | 57(10) | 1.64(0.71 to 3.82) | 56(17) | 1.52(0.78 to 2.98) | 46(15) | 1.43(0.66 to 3.09) | |
Retirees3
| 167(31) |
0.52(0.30 to 0.93)
| 138(25) | 1.02(0.42 to 2.47) | 240(30) | 1.02(0.42 to 2.47) | 198(24) | 0.90(0.32 to 2.52) | 198(57) | 1.41(0.89 to 2.23) | 166(48) | 1.01(0.42 to 2.41) | |
Household income | Low/middle | 250(61) | 1 | 222(55) | 1 | 377(48) | 1 | 335(44) | 1 | 320(96) | 1 | 286(86) | 1 |
High | 68(22) | 1.48(0.79 to 2.77) | 66(22) | 0.96(0.40 to 2.30) | 99(8) | 0.60(0.28 to 1.31) | 97(8) | 1.13(0.40 to 3.16) | 88(13) |
0.40(0.21 to 0.77)
| 87(12) |
0.36(0.15 to 0.84)
| |
Household fortune | Small/medium | 188(43) | 1 | 171(39) | 1 | 295(39) | 1 | 272(38) | 1 | 258(78) | 1 | 241(71) | 1 |
Large | 120(38) | 1.56(0.95 to 2.58) | 117(38) |
1.92(1.04 to 3.54)
| 165(14) | 0.61(0.32 to 1.16) | 160(14) | 0.59(0.30 to 1.18) | 136(29) | 0.63(0.38 to 1.04) | 132(27) | 0.76(0.42 to 1.38) | |
Smoking | No | 252(62) | 1 | 215(56) | 1 | 376(42) | 1 | 323(37) | 1 | 325(79) | 1 | 282(67) | 1 |
Yes | 82(24) | 1.27(0.75 to 2.14) | 73(21) | 1.06(0.59 to 1.92) | 126(17) | 1.24(0.66 to 2.31) | 109(15) | 0.99(0.49 to 1.99) | 105(35) | 1.56(0.99 to 2.46) | 91(31) | 1.25(0.70 to 2.22) | |
Alcohol intake per week4
| ≤21 | 297(73) | 1 | 258(66) | 1 | 449(51) | 1 | 389(46) | 1 | 384(98) | 1 | 335(84) | 1 |
>21 | 31(12) | 1.94(0.92 to 4.09) | 30(11) | 1.63(0.70 to 3.79) | 45(6) | 1.20(0.47 to 3.05) | 43(6) | 1.43(0.51 to 3.96) | 39(14) | 1.63(0.81 to 3.30) | 38(14) | 2.01(0.90 to 4.47) |